NEW CLIENT INFORMATION
Begin your journey to balance, healing, and whole-person wellness.
Welcome to Mandala Wellness — a sanctuary for your mind, body, and spirit in Ponte Vedra Beach, Florida. Whether you’re seeking relief from stress, navigating life transitions, or pursuing deeper healing, becoming a client here means stepping into a space rooted in compassion, connection, and personalized care. Our experienced team offers holistic services tailored to your unique needs, supporting you on a path to lasting wellness and balance. We’re honored to walk this journey with you.
NEW CLIENT INFORMATION
Begin your journey to balance, healing, and whole-person wellness.
Welcome to Mandala Wellness — a sanctuary for your mind, body, and spirit in Ponte Vedra Beach, Florida. Whether you’re seeking relief from stress, navigating life transitions, or pursuing deeper healing, becoming a client here means stepping into a space rooted in compassion, connection, and personalized care. Our experienced team offers holistic services tailored to your unique needs, supporting you on a path to lasting wellness and balance. We’re honored to walk this journey with you.
Client paperwork
Client paperwork for new Mandala Wellness patients and caregivers includes a records request, release forms, and credit card information for our clinics in Jacksonville and Ponte Vedra Beach, FL.
- The Scheduling Process
- Clinic Information
- Insurance Plans
- Billing Information
- Payment Methods
You will receive a call from a member of our client care team within 48 business hours after requesting an appointment request to discuss your concerns and obtain more information about the services you are seeking.
After reviewing insurance benefits, an intake appointment will be scheduled where you and your child will come to the clinic for a 1-2 hour session. At the conclusion of this session, the licensed clinician will discuss with you the services that are recommended and what you are interested in pursuing.
Further assessment and therapy sessions will be scheduled at this point, pending necessary insurance authorization.
Regular Clinic Hours are Monday – Friday, 9:00 am – 6:00 pm.
Please provide at least 24 hours’ notice prior to canceling an appointment. We understand when an emergency arises and ask that you provide as much notice as possible. If more than 3 or more cancellations or no-shows occur without notice, your child may be subject to discharge from services.
We accept most insurance plans although we are not always an in-network provider. In most cases, we accept the stated allowed amount from the insurance plan and only bill for the stated deductible and co-insurance.
Please talk to our staff to discuss your specific insurance plan and how we can accommodate you.
The client’s insurance policy is a contract between the client and his or her insurance company. Services and procedure codes associated with visits to Mandala may or may not be reimbursed by a client’s insurance carrier. The client assumes total responsibility for payment of these charges. As a courtesy, Mandala will file claims with the client’s insurance company and bill the insurer for all charges. If a client’s insurer does not pay for visits or a portion of the charges, the client understands that each client is responsible for any remaining balance on the client’s account. The client understands that verification of benefits is not a guarantee of payment by an insurance company.
We accept cash, checks, money orders and credit cards (Visa, MasterCard, Discover, and American Express)
Our policy requires full payment of all balances due each month. To facilitate this, we need a credit card of your choice to be placed on file authorizing the charge of full payment of your monthly invoice balance. Invoices will be mailed on the first Friday of the month, and the credit card will be processed on the third Friday of the month. Your invoice will be your notification of the amount that will be charged for the month.
We are willing to work with our client and make reasonable payment arrangements in certain circumstances.
Mandala Family Wellness accepts cash, check, and Zelle in addition to credit card payments for families who wish to avoid credit card transaction fees.
- Cash
If you prefer to pay via cash, please include your payment along with the associated invoice in an envelope. You may submit payment at any Mandala Wellness office location. - Check
To pay via check, please include your payment along with the associated invoice in an envelope. You can may submit payment at any Mandala Wellness front office location. - Zelle
Mandala Wellness is now accepting Zelle Payments. Zelle is a US-based digital payment recognized by most US banks. Please send your Zelle payment to accounting@mandalafamilywellness.com. You will receive an email from your bank confirming the payment. - Credit Card
If we do not receive an alternative payment arrangement by the date provided on your monthly billing statement, your credit card on file will be processed along with a 3.95% administrative fee.
You will receive a call from a member of our client care team within 48 hours of making an appointment request to discuss your concerns and obtain more information about the services you are seeking.
After reviewing insurance benefits, an intake appointment will be scheduled where you and your child will come to the clinic for a 1-2 hour session. At the conclusion of this session, the licensed clinician will discuss with you the services that are recommended and what you are interested in pursuing.
Further assessment and therapy sessions will be scheduled at this point, pending necessary insurance authorization.
Regular clinic hours are 9:00AM – 6PM
Please provide at least 24 hours’ notice prior to canceling an appointment. We understand when an emergency arises and ask that you provide as much notice as possible. If more than 3 or more cancellations or no-shows occur without notice, your child may be subject to discharge from services.
We accept most insurance plans although we are not always an in-network provider. In most cases, we accept the stated allowed amount from the insurance plan and only bill for the stated deductible and co-insurance.
Please talk to our staff to discuss your specific insurance plan and how we can accommodate you.
The client’s insurance policy is a contract between the client and his or her insurance company. Services and procedure codes associated with visits to Mandala may or may not be reimbursed by a client’s insurance carrier. The client assumes total responsibility for payment of these charges. As a courtesy, Mandala will file claims with the client’s insurance company and bill the insurer for all charges. If a client’s insurer does not pay for visits or a portion of the charges, the client understands that each client is responsible for any remaining balance on the client’s account. The client understands that verification of benefits is not a guarantee of payment by an insurance company.
We accept cash, checks, money orders and credit cards (Visa, MasterCard, Discover, and American Express)
Our policy requires full payment of all balances due each month. To facilitate this, we need a credit card of your choice to be placed on file authorizing the charge of full payment of your monthly invoice balance. Invoices will be mailed on the first Friday of the month, and the credit card will be processed on the third Friday of the month. Your invoice will be your notification of the amount that will be charged for the month.
We are willing to work with our client and make reasonable payment arrangements in certain circumstances.
Mandala Family Wellness accepts cash, check, and Zelle in addition to credit card payments for families who wish to avoid credit card transaction fees.
- Cash
If you prefer to pay via cash, please include your payment along with the associated invoice in an envelope. You may submit payment at any Mandala Wellness office location. - Check
To pay via check, please include your payment along with the associated invoice in an envelope. You can may submit payment at any Mandala Wellness front office location. - Zelle
Mandala Wellness is now accepting Zelle Payments. Zelle is a US-based digital payment recognized by most US banks. Please send your Zelle payment to accounting@mandalafamilywellness.com. You will receive an email from your bank confirming the payment. - Credit Card
If we do not receive an alternative payment arrangement by the date provided on your monthly billing statement, your credit card on file will be processed along with a 3.95% administrative fee.
For any billing questions, you may contact us via email at: billing@mandalawellness.com or by calling 904-834-7581
DISCLAIMER
Please be advised that you will need to reach out to to our front office at 904-834-7581 before filling the above paperwork to ensure that we have all what is needed in regards of your insurance plan.