The New Patient Forms are not always compatible with Internet Explorer. Please fill out the forms using a different browser.
The New Patient Forms are best completed on a desktop or laptop computer. You may experience problems submitting the forms if completed on a tablet or smartphone.
If you would like to come to our office as a new patient, please fill out the New Patient Forms. There is no need to call or inform our office, unless you have additional questions. The New Patient Forms take an estimated 10-15 minutes to complete, unless you have a detailed health history. Once your New Patient Forms have been completed and submitted to our office, we will call you to schedule your new patient appointment.
At Aligned Chiropractic, your first visit will begin with a warm smile and personal greeting! Please allow a total of two hours for your first in office visit.
If for some reason you will not be able to make your appointment, we request you provide at least 24 hours notice so that another person in need of the doctor's time may be helped.
New Patient Insurance
To see what insurances are considered in-network in our office click HERE.
If you have insurance you hope to utilize in our office:
Option 1: We will contact you after we receive your New Patient Forms. Completely fill out the Insurance Information section so that we may provide you with details on your insurance coverage in our office.
Option 2: Call our office to provide us with your insurance company name, ID number, date of birth, the subscriber name (and subscriber's date of birth if the subscriber is not you), and the phone number on the back of your card for provider services, or member services.
Option 3 : Email us via the Request Appointment button to the right and type in your insurance company name, ID number, date of birth, the subscriber name (and subscriber's date of birth if the subscriber is not you), and the phone number on the back of your card for provider services, or member services. You can not attach images via the Request Appointment option.
New Patient Medicare
If you are 65 or older or have Medicare, please email our New Patient Coordinator at [email protected] BEFORE filling out the online New Patient Forms.
We do not file with Medicare, or any secondary insurances affiliated with Medicare coverage. In many cases, we are able to provide maintenance care, or wellness care, for patients of Medicare age. In your email, please include your name and best telephone number to reach you.
Please click to fill out your New Patient Forms:
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Signature forms are completed at the time of your New Patient appointment at Aligned Chiropractic.
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