New Patient Forms

In order to save you time, please print out and fill out all the appropriate forms before coming to the office. Feel free to call us with any questions that you may have. Having the forms ready when you come to the office will enable us to keep our appointment schedules and minimize your time away from your home or work. You will have a few papers to fill out when you get to the clinic, but most of the papers will be completed from the website. Please read the lists below carefully for the forms that apply to you. If you need any help, please contact the office at 524-1234.

	Patients with or without Insurance, Group/Individual Insurance Plans For general insurance or those not filing insurance, click arrow to print form. SECONDARY INSURANCE - Please inform us of any secondary insurance you may have. We will assist you if you need help in filing.
	United Health Care Insurance If you have United Healthcare insurance, click on the arrow to print and fill out the appropriate forms.
	Cigna Paperwork If you have Cigna insurance, click on the arrow to print and fill out the appropriate forms.
	Personal Injury Forms If you have been injured by an accident, other than an Occupational or Motor Vehicle accident, click on the header to print and fill out the appropriate forms.
	Motor Vehicle Accident Forms If you have been injured in a Motor Vehicle accident or have been involved in an auto accident, click on the header to print and fill out the appropriate forms.
	Occupational Injury Forms If you have been injured on the job or if your injury is a result of your occupation, click on the header to print and fill out the appropriate forms.
	Massage Intake Form If you are interested in using our Massage Therapy services to relax and rejuvenate, please fill out this form.
	Hippa Policy and Procedures This form informs you of your rights and privileges as a patient and to fully disclose our policies with regards to distribution of your patient information.