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Self-pay Contract

Cost of Services

New Patient Exam

$50

Age 10 & under

$30

Monthly Option

4 for $200

Military Price

$54

Thoracic X-ray

$70

Adjustment & therapy

$60

Age 11-15

$40

Medicare-age Price

$45

Cervical X-ray

$60

Lumbar X-ray

$70

Agreement

Date
Day
Month
Year
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Address

210 Baber PK Dr W, Suite 120
Gallatin, TN 37066

Reclaim Your Comfort & Confidence

© 2025 by Go Chiro Pro

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