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Please use the following links to print and fill out our insurance coverage and patient health history forms. The forms are formatted in Adobe Acrobat, in order to view them you will need Adobe Acrobat Reader installed on your computer. If you do not have Adobe Acrobat Reader you can click here to download it FREE.
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GROUP OR INDIVIDUAL INSURANCE
We attempt to take out as much of the "insurance hassle" as possible for you. We'll happily telephone your insurance company to verify your coverage benefits. Please remember, however, that the benefits quoted to us by your insurance company are not a guarantee of payment. We will file your claim and await payment for 90 days. If your company pays the benefits they quote to us, the only services you will be responsible for are any non-covered services, deductibles or co-pays. If you have any questions at all regarding you financial responsibilities at our office, please do not hesitate to ask. Our insurance clerk has years of experience and will be happy to assist you. PATIENTS WITHOUT INSURANCE
An increasing number of patients do not have insurance, or have plans with limited coverage, such as catastrophic policies. We realize that no one wants to build up a large bill. Therefore, we have several plans so those patients may receive complete care without undue financial difficulty. Of course we are always happy to accept cash, your personal check, MasterCard, Visa, AMEX or Discover cards. Click here to fill out or update your insurance form PERSONAL INJURY OR AUTOMOBILE ACCIDENTS
First, may we say, we are sorry to hear of your accident. Accidents pose many challenges for you and for us, the healthcare provider. Please notify your auto insurance carrier of your visit to our office immediately. Notify our insurance department immediately if an attorney is representing you. Although someone else might be responsible for your accident, YOU are still responsible for your bill with us. Once the claim is settled or if you suspend or terminate care, any fees for services rendered are due immediately. If your insurance company fails to pay us directly and sends a payment to you, you MUST bring that check into our office to pay your balance with us within 1 week of receiving the check. Many accident cases are simple and easy, some go through the court system. We can wait only 6 months from your release date for full payment. Should your case go longer than this, we ask for payment in full at the 6 month period and you will be paid when your case settles. MEDICARE
We accept assignment from Medicare. Medicare only pays for the chiropractic manipulation part of your treatment. Medicare has a deductible requirement each year. Medicare pays 80% of the allowable fee once the deductible has been met. You are required to pay the deductible and the remaining 20% as well as any non-covered services. Our office completes and files the forms for Medicare at no charge. SECONDARY INSURANCE
Please inform us of any secondary insurance you may have. We will assist you if you need help in filing. WE DO NOT ACCEPT WORKMAN'S COMPENSATION CASES
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Patient Forms 
