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Who Should Fill Out Returning Patient Paperwork?

(If it's been > 6 months but< 3 years
OR you have a new condition/injury OR you've been in a car accident)

Welcome Back!

We're delighted to be your partner in health and honored that you have chosen to return to our office.

 

Whether it's been a while, you have a new condition or injury, or you've had a car accident, you'll find everything you need to prepare for your visit, including insurance information and guidance on updated paperwork.

 

We look forward to seeing you again!

Georgina says "hi"

Insurance change?

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

Car Accident?

​Kentucky is a "no-fault" state. This means no matter who is at fault, YOUR insurance pays your first $10K in medical expenses. This is called PIP coverage. 

Call YOUR insurance company and open a "PIP claim". Get this information:

  *  Claim #
  *  Claims Address and Phone
  *  Claim Handler Name
  *  Deductible Amount
 
You must pay your deductible before your company will cover any costs. We also offer services that your insurance may not cover. These items, if selected for your treatment plan, are eligible for our time-of-service discounts if paid up front.

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!

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

After you complete your updated paperwork...

** Choose "NO" for "Have you been to this clinic before?"

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

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Massage New Patient Information Form

Cold Laser Intake Form

Dry Needling Consent & Post Treatment Instructions

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Non-Surgical Decompression Traction Therapy Intake Form

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