New Patient Paperwork

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

• All forms are PDF files. You will need AdobeReader® to view them.
• If you do not already have AdobeReader® installed on your computer,
  Click Here to download.
• Download the necessary form(s), print them out and fill in the required information.
• Bring the necessary form(s) to your appointment.

Paperwork Instructions: (Generally 20 Minutes)

1. Please fill out this paperwork entirely in detail to the best of your ability
2. Bring completed paperwork into your appointment & do your best to arrive early to check in with front desk
3. Questions can be directed by phone to (586) 421-4356 or to yourwellnessdr@outlook.com
4. We have a busy practice & our time with our clients is very valuable! If you cannot make your appointment as scheduled, please be considerate & give us at least a 2 hour “heads up” so we can extend your appointment to others in need.

Cost of Appointment(s)

1. If you have insurance, we will have your coverage professionally verified & provide you a complimentary copy for your records. You are responsible for all deductibles, copay(s) or co-insurance(s) that are not covered per your contract b/w you & your Insurance Company.
2. If you are paying cash/credit/check, your investment will be $109 for adults/$60 children. This includes both your 1st & 2nd appointments with your first “official adjustment.” Appointments thereafter are $45/adult & $30/children or Care Plans can be purchased for long term care with will be covered during your Report of Findings visit.

Outline of 1st Visit: (30-40 Minutes)

1. Professional & Personalized Consultation
2. Professional Structural & Chiropractic ExaminationObjective assessment of your Nervous System with Thermography which indicates areas of spinal inflammation and depth of spinal stress. Surface EMG which indicates areas of spinal misbalance, muscular misfiring & spinal instability. Heart Rate Variability which indicates global health reserves & adaptability

Outline of 2nd Visit: (20-30 Minutes)

1. Report of Findings which covers the Problem/Partnership/Path/Plan for your Chiropractic Care
2. 1st Official Chiropractic Adjustment