Online Paperwork
We offer our paperwork online so you can complete it in the convenience of your own home. Here are the essential forms we use, and why we need them.
New Patient Paperwork
If you’re a new patient, you’ll want to start here. This download will provide you with a 6-page packet.
Pages 1 and 2 make up our Welcome section. They tell us about who you are, the reason for your visit, a bit about your health history, some basic emergency contacts, and your health insurance and other payment information.
Page 3 is a Pain Chart. This form allows you to show us where you are hurting.
Page 4 is our HIPAA Patient Consent form. It tells how we safeguard your protected health information. The form summarizes how we will only use your information to carry out treatment, payment, and other health care operations. The entire 5-page Privacy Notice that this form summarizes is available for your review by clicking on the appropriate link below.
Page 5 is the Informed Consent to Chiropractic Adjustments and Care. This form is important to read, as it essentially gives us permission to treat you. It outlines some of the rare, but inherent, risks to the procedures we perform — allowing for us to have an open dialogue about any questions or concerns you may have.
Page 6 is our New Patient Promise. This is our promise to you. While we realize that we cannot guarantee results, we can promise your satisfaction — satisfaction in knowing that consulting our office was a wise decision.
Accident Paperwork
If you’ve been involved in either an auto or work-related accident, you’ll need to download this paperwork as well. This 2-page supplement to the New Patient Paperwork, outlined above, will give us the additional information we need about your accident, any treatment you’ve already had, the symptoms that have resulted from the accident, how the accident has affected your activities, some questions about your actives in a typical work day, any applicable attorney information, and any additional insurance information (such as auto insurance).
Miscellaneous Paperwork
Insurance Worksheet
This is the download that you will want when calling to check on your insurance benefits for chiropractic and massage. The simple chart on this form makes the process easy by guiding you through the proper questions to ask. As a courtesy, we will be checking on your insurance benefits the day you arrive. However, through experience, we have found that when you check on the benefits yourself, not only will you gain a better understanding of what they are, but, perhaps more importantly, we will be able to cross-check the information that we both have been told. This will give everyone a greater degree of confidence in the insurance company’s explanation of your benefits.
Privacy Notice
Provided for your review in accordance with the Federal Government’s Health Insurance Portability and Accountability Act of 2003, this 5-page document gives a detailed account as to how we safeguard your protected health information. It specifically spells out how we will only use your information to carry out treatment, payment, and other health care operations. It outlines your rights and the requirements of that our office must adhere to. A summary of this document is included in the New Patient Paperwork.
Free AdobeReader®
Each form is a PDF document file. If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.
Patient Login
Free Newsletter
Dr. Lamar Asks...
