Online Forms

Science Based Wellness & Chiropractic offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, click here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

Download. Print. Complete.

Please print and complete your Chiropractic and Nutrition patient forms before you come into the office.

Patient Symptom Survey
Download & Print Form

New Patient Questionnaire
Download & Print Form

Daily Food Intake Log
Download & Print Form
| Example File

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Just as my services are unique, my financial policies differ from traditional healthcare.  The information provided is an explanation of my policies:

 

WHY I DO NOT ACCEPT MEDICAL INSURANCE

 

When medical practices bill health insurance companies, the doctors are required to  become participating providers.  The doctors are required to sign a contract that allows the insurance company to determine which services they will and will not provide and how much they can charge for those services.  In general, insurance companies are not focused on wellness or preventive services.  They are heavily invested in the conventional model of healthcare that often relies on drugs, invasive procedures, and surgeries.  As a Science Based Wellness physician, I am committed to prevention, wellness, and natural solutions to illness and disease.

 

A participating medical practice must agree to accept the fees the insurance company establishes, regardless of whether the fees are reasonable to that practice.  In general, these fees cover the cost of minimal, low quality care.  

 

Most doctors and clinics cope with the requirements of being participating providers by keeping office visits very brief, so they can see as many patients as possible within a given time frame.  Ironically, some of my patients complain about their extremely brief and unsatisfactory office visits at other medical practices.  As a physician who practices alternative medicine, I am extremely passionate about what I do.  My goal is to provide my patients with the highest quality natural healthcare available.  Unfortunately, I have found I cannot be a participating provider in the insurance networks to be able to provide the time-intensive and well researched care that I provide.

 

Note:  I do not profit from the sale of laboratory testing.  My patients pay me for my time, expertise, and the results I help them achieve.

 


We look forward to hearing from you

Office Hours

by appointment only

Mon - Thu

10:00 am - 5:00 pm

Fri

10:00 am - 6:00 pm

Sat, Sunday

Closed

Mon - Thu
10:00 am - 5:00 pm
Fri
10:00 am - 6:00 pm
Sat, Sunday
Closed

Location

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