Patient Forms

The following forms are for new chiropractic patients:

New Patient Intake Form (Online Document)

New Patient Intake Form (Printable PDF)

*As a new chiropractic patient, please bring a copy of your ID/Driver's License and insurance card.

*If you are not using health insurance, chiropractic visits are $99 as a new patient, and $49 for follow-up visits.

If you are interested in becoming a new chiropractic patient, please call our office to book an appointment.

Financing Information

We accept cash, check and the following payment options:

visa logo 2014 white
mastercard logo 4c5d228602
axp blueboxlogo extralargescale rgb digital 1600x1600 1
screen shot 2020 05 09 at 4.56.08 pm
screen shot 2020 05 09 at 4.56.56 pm
screen shot 2020 05 09 at 4.58.12 pm

Insurance Information


We accept insurance for chiropractic services from Aetna, Blue Cross Blue Shield, Cigna, Medcost, Medicare, and United Healthcare. We also accept Flexible Spending Accounts (FSAs) and Health Spending Accounts (HSAs).

If you have questions about your eligibility or coverage, please call our office. We are happy to help you!

Please note we do not accept insurance for med spa, aesthetic or wellness services.

Cancelation Policy

We understand that unanticipated events happen occasionally in everyone’s life. Business meetings, project deadlines, flight delays, car problems, snowstorms and illness are just a few reasons why one might consider canceling an appointment. In our desire to be effective and fair to all of our clients and out of consideration for our therapist’s time, we have adopted the following policies:

Canceling and Rescheduling

A 24 hour advance notice is REQUIRED when canceling or rescheduling any Spa appointment. This allows the opportunity for someone else to schedule an appointment during that time. If you are unable to give us 24 hours notice, you will be charged the FULL AMOUNT of your Spa appointment. All payments must be paid in full before further Spa appointments can be made. If you have a massage covered under insurance and are unable to give a 24 hour notice, a $20 cancellation fee will be charged to your card on file.

No - Shows

Anyone who either forgets, does not contact us within the times specified, or consciously chooses to forgo their appointment will be considered a no-show. You will be charged for your missed appointment and future service will be denied until payment is made.

Arriving Late

Appointment times have been arranged specifically for you. If you arrive late, your session may be shortened in order to accommodate others whose appointments follow yours. Depending upon how late you arrive, your therapist will then determine if there is enough time remaining to start your treatment. Regardless of the length of the treatment actually given, you will be responsible for the full session.

Out of respect and consideration to your therapists and their customers, please plan accordingly and be on time.


Click here for pricing information

Scroll to Top