New Patient Center

Forms

Fill out forms after downloading and printing at home – or fill them out directly online. You can return them in-person, or via email or fax. 

Depending on what type of appointment you have, some forms must be returned prior to the appointment.

Please fill out all forms thoroughly – and give us a call if you don’t know which one to fill out!

If needed, you can download and install AdobeReader(C) here

Physical Medicine Paperwork

Nutrition Program Questionnaire

Pediatric Paperwork

Nutrition Food Journal

Nutrition Program Evaluation

Auto Accident Paperwork

Medical or Functional Medicine Paperwork

Payment Options

Insurance

We work with all insurance plans, and are “In Network” with most major providers, including Medicare. Our physical medicine program also accepts auto-accident and personal injury cases that have resulted in acute and/or chronic pain.

No Insurance

For patients who have little or no insurance coverage or high deductibles, we offer payment plans for specific testing. We can also spread the cost of therapies in the clinic that are recommended by our medical providers.