| If you are a new patient at our
office, we will need information about you on your first visit.
In an effort to allow you the necessary time to fill out the required
paperwork, the forms can be mailed or faxed to you upon scheduling
your initial visit, or you may choose to download, print, and complete
the following forms. Please bring the forms with you
on your initial visit. It is not necessary to mail or fax them back
to us.
NEW
PATIENT INFORMATION
INFORMED
CONSENT TO CHIROPRACTIC TREATMENT
HIPAA
PRIVACY POLICY
Please be advised that full payment is due at the time services
are rendered. We are not contracted with any insurance companies,
but will provide you with a statement that you may file with your
carrier. Most insurance companies provide chiropractic coverage.
If you are unsure about your benefits, you may call the number on
the back of your insurance card to verify out-of-network chiropractic
coverage.
MEDICARE ONLY:
We are nonparticipating Medicare providers. Full payment is due
at the time services are rendered. We will file Medicare claims
requesting that reimbursement be sent directly to you, but please
be advised that Medicare reimbursement for our services is limited.
You will be asked to sign a Medicare form on your first visit detailing
this information. You may discuss any Medicare concerns with the
receptionist.
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