Patient Forms

If you would like us to direct bill your personal health insurance, then please fill out the Electronic transmission form and the Benefit Assignment form.

For Chiropractic Patients – If you are coming in for just chiropractic treatment please print and fill out the following forms: New Patient Form, Office Policies, and Consent Form – Chiropractic.

For Acupuncture Patients – If you are coming in for just acupuncture treatment please print and fill out the following forms: New Patient Form, Office Policies – Acupuncture, and Consent Form – Acupuncture.

For Massage Patients – If you are coming in for just massage therapy treatment please print and fill out the following forms: Patient Info, Patient Diagram, and Consent Form – Massage Therapy.

Insurance Billings – If you have insurance and would like us to direct bill your benefits please print and fill out the following forms: Benefit Assignment Consent Form and Electronic Transmission Consent Form.