Online Forms

As a New Patient to our office, you’ll need to fill out your Health History.  You may print the form and fill it out by hand, or download it, type in your information and print out the completed form. Please initial and sign where indicated once the form is printed, and bring it and all completed paperwork to your first appointment.

Also please print our Financial Policy, HIPAA Consent  and Request for Confidential Communication and Use of Email forms.  Print these forms, sign, date, and bring all of them with you to your appointment. By Law medical offices are required to take a copy of patient’s photo ID.

To read our entire HIPPA policy, click here.

If you are a Medicare eligible patient, please read this special notice.

If you have a Commercial Insurance Plan (United Healthcare, Blue Cross, etc.), and have out-of-network chiropractic benefits, please let us know upon arriving at your first appointment. We will supply you with an itemized superbill in order to be reimbursed for any covered services in which you are responsible to pay at each visit.

We also have an Updated Contact Information and Health History form available here if you are a current patient that may be seasonal or someone who has brand new injury. You may print our Updated History Form and bring with you to your next appoint.

For Pricing and Payment Options, please see our Fees and Payment Options page: click here

Please kindly give 24 hours notice for all cancellations, as our office may charge a missed appointment fee equal to the scheduled service fee.