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  • New Patient Forms (PDF)

  • Notice To Patients:

    Due to an exponential increase in the cost for insurance claim submission, we will be implementing an annual fee of $69.99 for all patients using insurance benefits for services in our office, effective January 1,2020.

    The annual fee will cover the extreme increase in claim submission fees via the insurance clearinghouse and allow us to continue to submit claims directly.

    We look forward to working with you in the years to come.

  • #1 New Patient Health History Form
    (Click To Download & Print Form)

  • #2 Notice Of Privacy Practices
    (Click To Download & Print Form)

  • #3 Financial Agreement
    (Click To Download & Print Form)

  • #4 Chiropractic Informed Consent To Treat
    (Click To Download & Print Form)

  • #5 Acupuncture Informed Consent To Treat
    (Click To Download & Print Form)

  • #6 Automobile Accident
    (Click To Download & Print Form)