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Welcome

At Fern Creek Chiropractic Center, we've been helping Louisville families achieve optimal wellness since 1997 through our unique blend of traditional chiropractic care and functional health approaches.

 

We're delighted that you've chosen us as your partner in health and are committed to making your experience exceptional from the start.

 

On this page, you'll find everything you need to prepare for your first visit, including insurance information, guidance on paperwork, and what to expect during your initial consultation.

 

We look forward to meeting you and supporting your family's wellness journey!

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Insurance

Insurance we accept:

Anthem or BC/BS (most), Aetna, All car insurance, Medicare ***MEDICARE: We are Non-Participating Providers. This means: We will file for you. You will pay us directly. ​Medicare will reimburse you (for services they deem medically necessary) 

 

Insurance we do NOT accept:

United, Cigna, Medicaid (any), Humana, Passport, Anthem Medicare, Work Compensation​

Will Insurance Cover Everything?

​The short answer is "no". Depending on the insurance plan you chose, you may have a deductible, copay, or coinsurance.
​
We also offer services that your health insurance does not cover. These items, if selected for your treatment plan, are eligible for our time-of-service discounts.
​
If you are filing with your car accident PIP insurance, most things are covered after you pay your deductible. However, some companies are denying some services.

Self Pay

No insurance, no problem!

If you are self-pay, we offer discounts for payment at the time-of-service. We, also, offer many of our services as packages to save you even more!

Who Should Fill Out New Patient Paperwork?
(never been to our office or its been > 3 years)

Click on only 1 of these bubbles to complete your
CONFIDENTIAL HEALTH RECORD

Step 1

Step 2

You will be redirected to our Intake Form when you complete your Paperwork below. If you do not, you may click on this link to go there. You may schedule your appointment here also.

What To Expect On Your First Visit

The initial visit, or New Patient Exam, typically consists of the following:​

​

  • Consultation

  • Initial Exam,

  • Neck and Low Back X-rays (if necessary)

  • Review of X-rays

  • Chiropractic Adjustment

  • Therapy (either Electrical Muscle Stimulation, Cold Laser, and/or Dry Needling).

 

This generally can be done in an hour, however, we do ask that you plan for an hour and a half to complete this visit depending on the detail of exams and review of your health history.

Therapy Paperwork
(If you are planning on utilizing any of these therapies, go ahead and fill these out)

Complete Your Paperwork Here

ALL NEW PATIENTS COMPLETE THIS FORM

IF AUTO ACCIDENT, ALSO COMPLETE THIS FORM

Confidential New Patient Health Record

Welcome to Fern Creek Chiropractic Center. Please take a few moments to complete this form to the best of your ability. The information provided in this form will help us achieve the best possible outcome. Note that information collected via this form is private and protected from disclosure by applicable law.

IMPORTANT: If this appointment is due to a CAR ACCIDENT, you will need to also complete the Auto Insurance & Car Accident Report form.

Personal Information

Birthday
Día
Mes
Año
Height (foot)
Height (inches)
Identify as...
Are you currently pregnant?
Yes
No
Unsure
How did you hear about our office?
Have you been to a chiropractor before?
Yes
No
What techniques were used by your previous chiropractor?

Employment Information

Employment Status

Health Insurance Information

**PLEASE NOTE: We will verify benefits and file your insurance as a courtesy to you. If your insurance company does not cover all of your services, you are responsible for payment. We will provide you with this information to the best of our ability. However, it is YOUR responsibility to know your coverage, eligibility, and, if you need a referral, to obtain this prior to your visit. YOU are ultimately responsible for your bill.

Who ELSE is responsible for your bill?
Health Insurance Carrier
Who is primary on your insurance?
Primary's Date of Birth
Día
Mes
Año

***IMPORTANT: If this is an AUTO ACCIDENT, you will give us the Auto Insurance information on the Motor Vehicle

Records Access & Release

I authorize the following person to have access to and to use or disclose the protected health information in my file at Fern Creek Chiropractic Center.

Primary Health or Injury Concern

Select
New Condition
New Injury
Exacerbation
Select area
Select side
How did this start?
Have you had a similar injury?
How often are you feeling this?
Select up to 6:
If pain radiates down an arm or a leg where to and how far?
Which side does it radiate to?
What makes it worse?
What makes it better?
When did this start?
When is it worst?
This condition is...

Secondary Health or Injury Concern

Select
New Condition
New Injury
Exacerbation
Select area
Select side
How did this start?
Have you had a similar injury?
How often are you feeling this?
Select up to 6:
If pain radiates down an arm or a leg where to and how far?
Which side does it radiate to?
What makes it worse?
What makes it better?
When did this start?
When is it worst?
This condition is...

Additional Health or Injury Concern

Select
New Condition
New Injury
Exacerbation
Select area
Select side
How did this start?
Have you had a similar injury?
How often are you feeling this?
Select up to 6:
If pain radiates down an arm or a leg where to and how far?
Which side does it radiate to?
What makes it worse?
What makes it better?
When did this start?
When is it worst?
This condition is...
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