NEW PATIENT CENTER
We understand that arriving at a doctor's office for the first time can be nerve wracking. Filling out paperwork, learning new faces and names, and getting to know your way around the office can be an overwhelming experience.
That's why at Dewald Chiropractic our aim is to remove any stressors causing unnecessary tension, and to make you feel comfortable. In this area of the website you will be able to take care of items necessary for your visit prior to arriving, in the comfort of your own home or office.
Remember to bring the following to your appointment:
- Driver's License
- Insurance card
- Cash, check or charge card for your co-pay or deductible.
- X-rays or MRI reports
- and any other information regarding your health history.
A valid major credit card is required at the time you book your appointment. Please note that any appointments that are rescheduled or cancelled with less than 24 hours notice your card will be charged for 50% of the cost of the scheduled service. Patients that do not show, and give no notice, will be billed the full amount for the visit. This is to ensure that all our patients have the best opportunity for appointment choice, and times aren’t held for people who aren’t planning on showing up. We do our best to consider each individual case, and rest assured YOUR CARD WILL NOT BE CHARGED unless the above occurs without reasonable cause.
Please be sure to turn cell phones and electronic devices off or set to
vibrate as a courtesy to our staff and your fellow-patients.
Patient Information & Health History - Required
We are unlike many offices who over book and run late. Out of respect for our patients, we are almost always ON TIME, so when we ask for you to PLEASE ARRIVE EARLY, we would greatly appreciate that you do so, allowing us to spend as much time as possible with your treatment time.
*If this information is not completed prior to your visit we may have to reschedule your appointment.
- ONLINE REGISTRATION -Please be sure to COMPLETE this form online and then press 'SUBMIT'. If you have not spoken with us directly, or requested an appointment by clicking the box to the right, you must do so, so that we know to look for your form.
For the following forms, please print out form, complete, and bring with you to your appointment to save paperwork time and increase your treatment time.
- ASH/CVT/SISC 1st Visit Authorization Packet - In additon if you have ASH, CVT or SISC insurance you must also click the link below to print out the ASH Authorization packet.
- ASH / CVT/ SISC Existing Patient Follow up Re-Exam Forms - If you are an existing patient with ASH, CVT or SISC, please print out these forms needed for your visit to save time.
- PERSONAL INJURY PACKET - If you are a Personal Injury (PI/ Auto Accident/Slip & Fall) patient in addition to the "New Patient Information" above you must also fill out the paperwork & bring it in with you during your visit.