New Patients

WC and PI Patients 

Additional Items

1. Financial Information        and Informed Consent 

2. Patient Intake Form         and Health History

1. Personal Injury Intake    

    Form

2. Personal Injury         Insurance Log

3. Medicare Financial           Information Chiro       

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4. HIPPA Information

5. TOS Financial and     

    Informed Consent

3. Pain Questionnaires 

4. Motor Vehicle           Accident Form

5. Attorney and 

    Insurance Lein

6. Assignment

    Authorization

1. Patient's Guide to       Insurance

2. Dry Needling Packet

3. Records Release