New Patient Paperwork


In order to save you some time in our office, we offer the ability for you to print out all of the necessary paperwork that we'll need for your first visit.  Please have all of the appropriate forms completed prior to your scheduled appointment time.  If you have any questions, please don't hesitate to call the office.  We are here to help you and make your experience in our office as pleasant as possible.

The paperwork that you will fill out depends on the type of patient you will be.  If you are seeking treatment as a result of a car accident, on the job injury or slip and fall type injury, choose the appropriate paperwork below.  All other patients will need to fill out the Health Insurance/Cash Patient paperwork.  Again, if you have any questions as to what type of patient you will be, call our office, we are here to help.

Dr.Montgomery is a preferred provider with most major medical insurance companies, please call the office if you have any questions. Our friendly staff will take the time to answer any questions that you may have. We offer a free initial consultation and a safe and gentle environment for your chiropractic and massage therapy needs.
 

Health Insurance/Cash Patient

New Patient Questionnaire

HIPPA Form


Slip and Fall

Slip and Fall Questionnaire

Neck Pain

Low Back Oswestry

HIPPA Form

 

Car Accident

Accident Questionnaire

Neck Pain

Low Back Oswestry

HIPPA Form


On The Job Injury

The Injury Questionnaire

Neck Pain

Low Back Oswestry

HIPPA Form