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No Surprises Act, 2022

According to the No Surprises Act effective starting January 1st, 2022, a Good Faith Estimate must be supplied to any individual who is uninsured, or who has insurance but chooses not to use it for care provided here at Rejuvenate, llc.


According to bill §149.610(b)(1)(iii)(A-C) (, uninsured or self pay patients must be informed of the availability of a good faith estimate of expected charges upon scheduling an item or service.  This estimate can be requested from Rejuvenate’s front office by calling 406-677-7722, or by email at  The requested good faith estimate will be provided to you within 1-3 business days.  This information will also be provided by Rejuvenate staff verbally when scheduling a self pay service, or when questions about the cost of services occur.  A good faith estimate provided by Rejuvenate, llc will be within $399 of the actual charges to the patient, as required by the act stated above.


If you have any further questions about this policy or would like to request a Good Faith Estimate for care, you can do so by calling 406-677-7722 or by email to

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COVID-19 Precautions and Consent to Care:

Rejuvenate is requiring the following Protective Protocols:

- Cancel your visit if you are sick

- Answer Screening questions upon entry

- Allow your temperature to be taken upon entry

- Do not bring anyone with you to your appointment

- If possible, leave coats, bags, and personal belongings in your car

- Wash your hands for 20 seconds with soap and water once inside the clinic

- Wear an approved protective mask: Dual or Multi-Layer fabric, or medical masks

- Limit touching your face, and touching any surfaces as much as possible

- Wash your hands with soap and water for 20 seconds after each bathroom use

I acknowledge that I am at high risk if I become infected with COVID-19 due to the following (Check All That Apply)

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