Please print these forms and fill out completely before your first visit.
If you are unable to print these forms please come in 20 minutes ahead of your scheduled appointment or call us to fax or mail you the forms.
Please use the following links to print and fill out our insurance coverage and patient health history forms. The forms are in the PDF format; in order to view them you will need a PDF viewer such as Adobe Reader. If you do not have Adobe Reader you can click the following button to download it FREE.
Get Adobe Reader
__________________________________________________________________________________________________
Please have forms completely filled out & bring them to your first visit.
This will allow you to have the full time with one of our doctors.
Thank you!
Chiropractic Forms:
(All Chiropractic patients)
(under 12 years old)
Nutrition Response Testing Forms:
Sauna Release Form:
__________________________________________________________________________________________________
GROUP OR INDIVIDUAL INSURANCE:
Please call your insurance company to find out your chiropractic benefits before your first visit.
PATIENTS WITHOUT INSURANCE:
We offer affordable cash plans. Ask for more information when you visit us. We accept cash, check, Visa, Mastercard, and Discover.
We accept:
AUTO, PERSONAL INJURY, WORKER'S COMPENSATION
Please have your claim number available when you come to our clinic.
|
Patient Forms
