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Westenhaver Chiropractic offers our patient form(s) online so they can be completed it in the convenience of your own home or office.
This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know! Please download and print each of these links below.
Please select the following forms below to match your situation - Please choose only one bolded section below.
General Insurance and Self Pay forms - Please print these forms in addition to the intake forms if we will be billing your general health insurance or you will be paying out of your pocket for all services rendered.
Group Health- Please print these forms out in addition to the intake forms if we will be billing Group Health insurance for you.
Medicare Forms- Please print the following forms out in addition to the intake forms if we will be billing Medicare for you.
Workers Compensation Form - Please print the following forms out in addition to the intake forms if we will be billing a work compensation insurance for you.
Auto Accident Form - Please print the following forms out in addition to the intake forms if we will be billing for an auto accident for you.
Massage Therapy Paperwork- Please print the following forms out if you are coming to our office for massage therapy.
|Monday||8:00 - 11:00||3:00 - 6:00|
|Tuesday||3:00 - 6:00|
|Wednesday||8:00 - 11:00||3:00 - 6:00|
|Thursday||8:00 - 11:00||3:00 - 6:00|
|8:00 - 11:00||3:00 - 6:00||8:00 - 11:00||8:00 - 11:00||Closed||Closed||Closed|
|3:00 - 6:00||3:00 - 6:00||3:00 - 6:00|
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