New Patient Forms

            COST:     Initial Consultations $125 - - - Ongoing Consultations $80

                  1.  Cash    on     day    of    Consult

                  2.  Pre-Pay    to:        Acct. Name:    Mark S. Borsuk  (ANZ)

                                                           BSB #                012754 

                                                           Acct. #              586081177 

                                  MY PRACTICE RULES

  • Please no phone calls in the waiting area.

  • Please Park directly in front of my home or directly across the street.

  • Please be quiet & courteous to my neighbors.

  • If accompanied by children, please keep them seated quietly or in the

            children’s area.

  • I require 24 hour notice for re-scheduling of your appointment, if missed;

             you are responsible for payment.

  • I don’t respond to “UNKNOWN” or “PRIVATE” NUMBER  on my phone. If you want to speak with me, make sure your number is visible to me.

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