Your First Visit
Your first visit includes examination, discussion, and treatment. It will be up to 45 minutes in length.
· Follow up visit/treatments are at least 20 minutes each.
Things to bring on your first visit:
· Driver’s license / identification
· Insurance information / card, you want to bill insurance
· Claim letter of third-party liability if this is the case
· Wear comfortable clothing that allows movement
You’ll need to fill out and sign three forms.
You can either:
(a) Arrive 15 minutes before your appointment and we’ll provide you with these forms to fill out and sign.
or (b) Download the forms now, fill them out, and bring them with you:
· Informed consent for Chiropractic Treatment
· Cost of care: Patient Responsibility for Non-Coverage
· HIIPA Privacy and Communication Practices
Be sure you have all your questions answered before signing these forms.
· Follow up visit/treatments are at least 20 minutes each.
Things to bring on your first visit:
· Driver’s license / identification
· Insurance information / card, you want to bill insurance
· Claim letter of third-party liability if this is the case
· Wear comfortable clothing that allows movement
You’ll need to fill out and sign three forms.
You can either:
(a) Arrive 15 minutes before your appointment and we’ll provide you with these forms to fill out and sign.
or (b) Download the forms now, fill them out, and bring them with you:
· Informed consent for Chiropractic Treatment
· Cost of care: Patient Responsibility for Non-Coverage
· HIIPA Privacy and Communication Practices
Be sure you have all your questions answered before signing these forms.
Our Policies
Please review our policies. You can download any or all of them. Call us if you have any questions.
2022 Fee Schedule: We derive our fee schedule from CMS.gov Centers for Medicare and Medicaid Services with a conversion factor of 150%. These are the rates and codes you will see on your Explanation of Benefits (EOB).
Privacy Practices: We protect your health information. Therefore, we ask how we may communicate with you outside of the office – phone, text and voice mail.
DHCS HIIPA: Department of Health Care Services in California guidelines on how to protect and communicate with your health information.
Informed Consent: Informed Consent describes the risk and benefits of chiropractic care.
Cost of Care: We have two rates and three discounts detailed in our Advanced Notice of Non-Coverage form.
Medicare Cost of Care: Medicare cost of care is one low flat rate fee and is described in the Advanced Beneficiary Notice.
Auto Accident Cost of Care: If you are involved in an auto accident, we have several options of care. We do not currently work on lien.
2022 Fee Schedule: We derive our fee schedule from CMS.gov Centers for Medicare and Medicaid Services with a conversion factor of 150%. These are the rates and codes you will see on your Explanation of Benefits (EOB).
Privacy Practices: We protect your health information. Therefore, we ask how we may communicate with you outside of the office – phone, text and voice mail.
DHCS HIIPA: Department of Health Care Services in California guidelines on how to protect and communicate with your health information.
Informed Consent: Informed Consent describes the risk and benefits of chiropractic care.
Cost of Care: We have two rates and three discounts detailed in our Advanced Notice of Non-Coverage form.
Medicare Cost of Care: Medicare cost of care is one low flat rate fee and is described in the Advanced Beneficiary Notice.
Auto Accident Cost of Care: If you are involved in an auto accident, we have several options of care. We do not currently work on lien.