Patient Forms

Please fill out the necessary forms below before arriving for your appointment.  Please take the time to fill them out completely and to the best of your ability, as this information is needed to provide you with the most appropriate and effective care.  Our staff will direct you as to what forms you will need to fill out before arriving.

New Patient General Insurance
Download

Physical Therapy
Download

Acupuncture
Download

Pediatric
Download

Personal Injury
Download

Workers’ Compensation
Download

New Patient Medicare
Download

Self Pay
Download

X-ray Only
Download

 

Insurance and Payment Information

We are contracted providers for many insurance plans; please call your insurance company to verify your benefits prior to coming in.  Please be aware that copays are due at the time of service.  If you have a high deductible plan, we recommend paying $50 each visit,

Payment methods accepted are: Visa, MasterCard, Discover, Cash, Personal Check

REMEMBER…

Please make sure to bring the following with you for your first appointment:

  • Insurance Card and driver’s license if possible.
  • Copies of any previous diagnostic studies or reports such as, X-rays, MRI’s, EMG/NCV reports.