Your First Visit

Chiropractic Adult Intake Form: New Patient, 13years+

Chiropractic Pediatric Intake Form: New Patient, birth-12years

Functional Medicine/Nutrition Counseling Health History: Must complete prior to first Nutrition Counseling appointment

Massage Intake Form
Advanced Functional Medicine/Nutrition Counseling Intake
Medical Release Form (Need not complete unless specifically reqeusted by the doctor or office)
Auto Injury Intake Form
Established Patient Information/Update Form (Established Patient must complete prior to first appointment of 2016)
Notice of Privacy Practices

Our office does not determine your chiropractic benefits

Our relationship is ultimately with you and not your insurance company. Your health insurance is a contract between your employer and the insurance company. The percentage covered for each procedure is determined by how much your employer has paid for coverage. We will request information prior to your initial visit for our files and have guidance on how to collect payment.
We offer a very affordable “Time of Service Plan” for those who choose not to utilize their insurance, have a high deductible plan or do not have chiropractic benefits. Details of our Time of Service Plan are included in the Chiropractic Adult Intake Form above.
For your convenience, we accept cash, personal checks and most major credit cards.