This lets us know of your rights as a patient and, in particular, the proper care and handling of your medical and personal information as per the federal Health Insurance Portability and Accountability Act (HIPAA)
This form lets us know that you are aware of the information that the Doctor can share your treatment options with you so you can make the best decision for yourself.
In order for us to render pediactric chiropractic services, we will need you to fill out the form below. This forms provides us with information needed to better treat your child. Please call if you have any questions!
