New Patient Information

New Patient Information

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Welcome to Our Practice

Thank you for choosing our chiropractic clinic for your healthcare needs. To provide you with the best possible care, please complete the following form. All information is confidential and will be maintained securely in accordance with applicable privacy laws.

If you have any questions while completing the form, please don't hesitate to call our office at (570) 868-3527.

What to Expect

First Visit

Your initial appointment will include a consultation, examination, and treatment. Please arrive 15 minutes early.

Bring With You

Please bring your ID, insurance card, this completed form, and any relevant medical records or imaging.

Insurance

We accept most insurance plans. Contact us to verify your coverage before your appointment.

New Patient Form

Completing this form ahead of your appointment will help streamline your first visit. If you have any difficulties downloading or printing the form, we will have copies available at our office.

New Patient Form - Click To Download PDF