Plus Plan Enrollment

In which market are you enrolling? *

Have you ever received decompression treatment at an IMAC Regeneration Center? *

Name *

First

Last

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Pre-existing medical conditions *

Allergies
Asthma
Back Pain
Broken Bones
Chest Pain
COPD
Epilepsy/Seizure
Fainting
Headaches
Heart Conditions
High Blood Pressure
Medically Implanted Devices
Neck Pain
Open Heart Surgery
Pacemaker
Previous Spine Surgery
Other Recent Surgery
Tachycardia
None

Plus Plan Monthly Recurring Membership *

Price: $ 95.00

I agree to annual enrollment with IMAC Regeneration Center for the Plus Plan described. I acknowledge and understand that my agreement to the fees listed is based on annual assessment of pricing. My annual fee is non-refundable and is not dependent on cancellation of any or all services. Annual Membership Fee will be due at time of initial examination.

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Unfortunately, You don't qualify for this plan. Please select a different plan or contact us for more information

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Disclaimer for Plus Plan:

IMAC Regeneration Centers have the right to amend Plus Plan at any time. Member will be given a 30 day written notice of any such change and has the option to cancel without penalty upon such notice.

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