Patient Forms
In order to keep our patients’ wait time in the office to a minimum, we have posted all necessary forms needed for your visit.
We have categorized the forms based on whether you are a new chiropractic patient, an existing patient, had a personal injury, or a work injury. Please choose which category best fits you. Open, print, and complete the paperwork. Please bring all forms to your appointment.
Taking advantage of our online forms allows you to relax when you arrive!
You are strongly encouraged to watch this video to ensure your insurance success.
- Download Your Patient Form
Are you a new or returning patient?
NEW/RETURNING PATIENT FORMS
Are you a new patient or returning patient with Medicare?
NEW/RETURNING PATIENT FORMS
Are you a new patient with United Health Care Insurance?
NEW PATIENT FORMS
Are you an existing patient with United Health Care Insurance?
PATIENT FORMS
Have you had a personal injury?
NEW PATIENT FORMS
Have you been injured at work?
NEW PATIENT FORMS
Keys to Insurance Success
It is our goal to only educate and advise you on what insurance companies are looking for when submitting claims.
From our experience, we can tell you that insurance companies are concerned with specific information in a very specific order.
To successfully submit your claims for consideration, it is vital that you answer all questions thoroughly. Otherwise, there’s a possibility that your claims will be denied.
- Be specific with all your ailments no matter how small or large.
- State every symptom you are feeling.
- Zero pain levels will not get your claims paid, so be honest and reasonable with your pain levels. Use the chart that is provided with your paperwork.
- List out how your symptoms interfere with your daily life such as work, home, and in your social life.
- It is vital that you keep your insurance company aware of reoccurring problems, symptoms, exacerbated conditions, and new injuries large or small.
- Areas of the neck, back, low back, and extremities require symptoms in order to be treated.
We look forward to seeing you at your first appointment and assisting you with your healthcare and insurance needs.
This is strictly an opinion of Strelcheck Chiropractic Clinic and is not in any way, shape, or form to be regarded as a legal statement.
