New Patient Forms

We encourage you to fill out the following new patient forms and bring them with you to your first visit.  If you have any questions about the form content, please do not hesitate to call us prior to your visit, or we can answer your questions upon your arrival at our office.  We advise you to arrive at least 15 minutes prior to your first scheduled appointment to ensure you have enough time to complete the necessary paperwork.

  • New Patient Registration Form - Word and PDF Format
  • Health History Form - Word or PDF Format
  • HIPPA Privacy Form - Word or PDF Format
  • Terms of Acceptance Form - Word or PDF Format
  • Consent to Treat a Minor Form - Word or PDF Format
  • Payment Policy Form - Word or PDF Format
  • Insurance Verification Form - Word or PDF Format

If your visit to Metcalf Chiropractic Health Center is the result of a recent accident, please fill out the additional accident forms and bring them with you to your first visit.

  • Accident Information Form - Word or PDF Format
  • Payment Authorization Form - Word or PDF Format
  • Records Transfer Authorization Form - Word or PDF Format

Care Credit Healthcare Finance

Care Credit, a GE Money Company, gives you convenient payment options so you can get the Chiropractic care you want, when you want it.  Please print and fill out the downloadable application form and bring it with you on your next visit to Metcalf Chiropractic Health Center.

Learn more and download the application form at:  http://www.carecredit.com