Service Description: This Good Faith Estimate is provided to you for the physical therapy and/or wellness services that are anticipated to be provided by Form & Focus: Rehab & Wellness. The estimate is based on the information known at the time of the estimate and may vary depending on your specific needs and the actual services provided.

Important Information:

This Good Faith Estimate provides an estimate of the total expected cost of the non-emergency healthcare items or services listed. It is not a contract and does not obligate you to obtain the services from Form & Focus- Rehab & Wellness.

The actual items, services, and costs may vary based on your individual needs and the course of treatment.

Initial Services

Sessions are 60 minutes in length.

Initial Meet & Greet ($100) 

Pay-As-You-Go ($200)

Member Benefits

Joining a Monthly Membership Plan means you get more than just sessions — you become a priority client. Benefits include:

Priority scheduling (first pick of days/times)

Direct call or text access to your PT

Same-week rescheduling preference

Ability to bank up to 3 make-up sessions

Monthly Form Membership Plan

LSVT Big ($2,400)

3x/week ($1,800)

2x/week ($1,200)

1x/week ($600)

Monthly Focus Membership Plan

2x/month ($350)

💳 Payment Policy:

• Payment is due by the 25th of the prior month if not using card on file

• A 5% credit card fee applies

• Payments accepted: Cash, Check, Venmo (@formandfocusrehab), or Zelle (katherine@formandfocusrehab.com

Failed Appointment/Late Cancellation Policy 

Appointments must be cancelled by 9AM the previous business day or you will be charged the full session fee rate for a failed appointment or late cancellation. This means that Monday appointments need to be cancelled by Friday at 9AM. Any charges applied will need to be paid prior to your next visit. Please note that insurance companies do not reimburse for cancelled or missed appointments and that you are solely responsible for these charges. A failure to receive an email reminder does not waive the fee. If you need to cancel your appointment, please email katherine@formandfocusrehab.com or call/text/leave a voicemail at (586) 646-8010. 

Make-up sessions

If you provide a cancellation notice within a timely manner or if the physical therapist cancels your appointment in a timely manner, you can reschedule or make up that session that same week or another week, depending on availability. You can bank up to a maximum of 3 make-up sessions during your time with Form & Focus- Rehab & Wellness.

Discharge from Physical Therapy or Services

If you want to cancel or be discharged from physical therapy for the next month, please give a courtesy notice by the 15th of the previous month for optimal scheduling.

Contact Information:

Katherine Andary, PT, DPT

Form & Focus: Rehab & Wellness, PLLC

Tel: (586) 646-8010

Email: katherine@formandfocusrehab.com