Chiro & Acupuncture Inc. offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic office.

 

• If you do not already have AdobeReader® installed on your computer, Click Here to download.

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• Download the necessary form(s), print it out and fill in the required information.

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• Fax us your printed and completed form(s) or bring it with you to your appointment.

 

We Accept Insurance!

We accept many in-network insurance plans for our services and some out-of-network plans may have available benefits. Our team will verify your coverage and benefits during your initial visit, as coverage varies by individual plans and does not guarantee payment. Please note that we are not in-network with Medicare, but we’re happy to discuss any coverage questions you may have.

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Call us prior to your appointment and we'll help you figure out your benefits: 817-552-7246. 

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New Patient Health History Form - **Required**

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

 

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Download the Free AdobeReader®