Chiro & Acupuncture Inc. offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic office.

 

• If you do not already have AdobeReader® installed on your computer, Click Here to download.

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• Download the necessary form(s), print it out and fill in the required information.

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• Fax us your printed and completed form(s) or bring it with you to your appointment.

 

We Accept Insurance!

We accept most of the in-network insurances for our services and some out of network plans have available benefits. Dr. Lee is also a Medicare provider and has helped many patients get on the right track towards a better health.  We will check your coverage and benefits upon your arrival to the initial treatment session. The coverage is dependent on the individual plans and does not guarantee payment.

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Call us prior to your appointment and we'll help you figure out your benefits: 817-552-7246. 

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New Patient Health History Form - **Required**

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!

 

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Download the Free AdobeReader®