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As a designated provider for most insurance companies and Medicare, we will file for
payment of covered charges with your insurance carrier. In order to properly file your
claim we will require a copy of your insurance card and your photo ID at the time that
you check in for your first appointment. If Medicare is your primary carrier, you are
required to have a prescription from your physician before receiving treatment.

If your injury is related to an accident in litigation or a worker’s compensation claim
we will handle your claim as required. Please complete the Litigation/Accident form
and bring all relevant documentation including your claim number and representative
contact information.

To help expedite your first visit to our office, please download, fill out, and print the
following forms. All of these forms are in PDF format and can be viewed in your
browser or using Adobe Acrobat Reader.

Patient Information Form
Financial Responsibilities Form
Litigation/Accident/Injury Statement

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