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New Patient Intake Forms

General Intake for Adults
Pediatric Intake
Car Accident Intake

You may fill out the forms online and then email them to ahead of your appointment.


Otherwise you can print them at home and bring them with you to your appointment.

Blank copies are also available in the office.


Do you take insurance?

We do not accept insurance and we do not bill insurance. We are considered out-of-network. Many PPO insurance plans cover one or more of our out-of-network services. At your request, we can provide you with a super bill to submit to your insurance for potential reimbursement.  There are many different plans and coverage varies widely.  We recommend you contact your insurance provider before your appointment to find out exactly what benefits are covered. We do not guarantee that any reimbursement will be issued.

What is the vertebral subluxation? 
Your spine is made up of small joints called vertebrae. When these small joints get slightly misaligned due to repetitive stress or the strain of pregnancy, it irritates the nerves. When the nerve isn't functioning correctly, it can result in symptoms related to organs, muscles, and systems of the body.


How does a subluxation occur? 
Any major or even minor spinal trauma or prolonged stress or strain can cause the vertebrae, or pelvic bones, to become misaligned, resulting in a subluxation. This is common during pregnancy with the addition of 25 - 35 pounds or more, change in sleeping position and change in center of gravity.


What is a chiropractic adjustment?  
Chiropractic adjustments move the vertebrae back into place, removing nerve interference and allowing the body to improve its function, resulting in a better expression of heath.


Can women who are pregnant receive chiropractic care? 
Of course! Many pregnant women report back to their chiropractors the tremendous benefits they've received through regular prenatal chiropractic care. 


What is the Webster Technique? 

The Webster Technique is a specific chiropractic analysis and adjustment of the sacrum. The goal of the adjustment is to reduce the effects of sacral subluxation and sacroiliac joint dysfunction. In doing so, neuro-biomechanical function in the pelvis is facilitated. In short, it is used to improve the function of bones, joints and soft tissues around your hips and pelvis.


Can a chiropractic adjustment turn a breech baby? 
Chiropractors do not perform any obstetrical services and we do not turn breech babies.  We are really great at improving function of pelvic muscles, tendons, ligaments, and joints which optimizes the environment around the baby.


Do medical doctors refer to chiropractors? 
Yes, there is a growing trend of obstetricians, pediatricians, and family doctors referring patients for chiropractic care as they see the benefits of spinal adjustments. They recognize that this is out of the scope of their practice.  Many of our referrals come from medical doctors and many of our patients are medical doctors.


Are chiropractors anti-medical doctors? 
No, your family wellness chiropractor recognizes the important role that a medical doctor plays in your family's health and believes in a team approach. When we suspect that you need medical attention we will make an immediate referral.


What if my medical doctor tells me not to see a chiropractor while I am pregnant? 
Many obstetricians, pediatricians, and family practitioners see the benefits of chiropractic care for pregnancy, but there are some medical doctors who are unsure of what we do or are skeptical of chiropractic care. If your doctor tells you not to see a chiropractor while you are pregnant, we suggest asking for more specific information as to what the concerns are (including documented resources). On occasion, your doctor may support prenatal chiropractic care but have concerns due to factors specific to your pregnancy. 


Can chiropractic care be affordable for my entire family? 
Families that receive wellness chiropractic care usually report an overall improved quality of life their family members. They further report with their improved health that they often are saving money on healthcare costs, which makes it affordable to have the entire family in chiropractic care. Of course, knowing that you've provided your child the opportunity to have a healthy adulthood is the greatest benefit.

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