New Patient Forms: Cash-Paying – Auto / Work Insurance – Commercial Insurance

With our new patient forms, it is recommended that you spend some time in a quiet place to reflect on the questions being asked, so that you and the doctor’s consultation time together can be most beneficial.

After completing your appropriate forms below, please bring these forms with you to your appointment. Please try to arrive on-time, so that you and the doctor can benefit for your alotted time together. New patient appointments are usually about 60-75 minutes, and sometimes slightly longer or shorter, depending on what the doctor understands to be the holistic underlying causes of your health concerns.

New Patient Cash-Paying forms:

• Confidential Patient Information
• Verification of Insurance Benefits
• Health Questionnaire

New Patient Auto / Work-related forms:

• Subsequent Patient Form

New Patient Commercial Insurance forms:

• Confidential Patient Information
• Verification of Insurance Benefits
• Automobile Accident Questionnaire
• Accident/Injury Questionnaire
• Health Questionnaire

Subsequent office visit form for auto accident patient

• Subsequent Patient Form

New medical insurance patient forms

• Confidential Patient Information
• Verification of Insurance Benefits
• Health Questionnaire

Subsequent office visit patient form using medical insurance

• Subsequent Patient Form

New work-injured patient forms

• Confidential Patient Information
• Verification of Insurance Benefits
• Accident/Injury Questionnaire
• Health Questionnaire

Subsequent office visit patient form for a work injury

• Subsequent Patient Form