Please use the following links to print and fill out our new patient 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 here to download it FREE.

GROUP OR INDIVIDUAL INSURANCE
We attempt to take out as much of the "insurance hassle" as possible for you. We'll happily telephone your insurance company to verify your coverage benefits. Please remember, however, that the benefits quoted to us by your insurance company are not a guarantee of payment. We will file your claim for you but you will be responsible for any non-covered services, deductibles or co-pays at the time of service. If you have any questions regarding you financial responsibilities at our office, please do not hesitate to ask. Our insurance clerk has years of experience and will be happy to assist you.

PATIENTS WITHOUT INSURANCE
An increasing number of patients do not have insurance, or have plans with limited coverage, such as catastrophic policies. Of course we are always happy to accept cash, your personal check, MasterCard, Visa, American Express or Discover cards.

"ON THE JOB" INJURY (Worker’s Compensation)
Our office does not accept worker's compensation.

PERSONAL INJURY OR AUTOMOBILE ACCIDENTS
Please notify your auto insurance carrier of your visit to our office immediately. Notify our insurance department immediately if an attorney is representing you. Although our office does not accept 3rd party claims (the other persons insurance) we will file on your PIP or personal health insurance for you.

MEDICARE
We do not accept assignment from Medicare. You are required to pay in full at the time of service. Our office completes and files the forms for Medicare at no charge. The check is usually sent directly to the patient for payment of the services that Medicare will cover, which for Chiropractors is ONLY manual manipulation of the spine. Medicare pays 80% of the allowable fee once the deductible has been met.

SECONDARY INSURANCE
Please inform us of any secondary insurance you may have. We will assist you if you need help in filing.