Castle Rock Chiropractor | Castle Rock chiropractic care | CO | Patient Forms

4344 Woodlands Blvd, Ste 120
Castle Rock, CO 80104

(303) 814-5940

Patient Forms
 

Please use the following link to fill out our new patient forms. The forms can be submitted online. Please click on the 'SUBMIT' button at the bottom of the forms to send them to our office.


New Patient Forms 

 

GROUP OR INDIVIDUAL INSURANCE

We attempt to take out as much of the "insurance hassle" as possible for you. We'll happily telephone your insurance company to verify your coverage benefits. Please remember, however, that the benefits quoted to us by your insurance company are not a guarantee of payment.  If your company pays the benefits they quote to us, the only services you will be responsible for are any non-covered services, deductibles or co-pays. If you have any questions at all regarding you financial responsibilities at our office, please do not hesitate to ask. 

PATIENTS WITHOUT INSURANCE

If you do not have insurance that would contribute to your care, we have several plans so that you may receive complete care without undue financial difficulty. We are always happy to accept cash, Care Credit, your personal check, MasterCard, Visa or Discover cards.

PERSONAL INJURY OR AUTOMOBILE ACCIDENTS

Please notify your auto insurance carrier of your visit to our office immediately. Notify our insurance department immediately if an attorney is representing you.

SECONDARY INSURANCE

Please inform us of any secondary insurance you may have. We will assist you if you need help in filing.

 
 
 
Castle Rock Chiropractor | Patient Forms. Dr. Thomas Bithell is a Castle Rock Chiropractor.