- Please fill out forms completely in blue or black ink only.
- ALL NEW PATIENTS need to fill out the NEW PATIENT INTAKE FORM.
- If your treatments are covered by an AUTO ACCIDENT CLAIM also fill out the AUTO ACCIDENT FORMS.
- If your treatments are covered by a WORKERS COMPENSATION CLAIM also fill out the WORKERS COMP FORMS.
- If the patient is UNDER THE AGE OF 18, then a parent or guardian must also fill out the CONSENT TO TREAT A MINOR FORM.