New-Patient Forms
If you’re coming to one of our clinics for the first time, please complete the forms below to save time at your first visit. We look forward to serving you!
As a patient of the Palmer Chiropractic Clinics, you have certain privacy expectations as well as rights and responsibilities. All of the Palmer Clinics are fully compliant with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) privacy and security rules for health care providers. The confidentiality of your patient records is of paramount concern to us, and you’ll be asked to review information about how we comply with HIPAA rules and sign a form on your first visit.
Your Privacy, Rights and Responsibilities
Cost
At Palmer Clinics, your first visit includes a consultation, history, exam and X-rays, if needed. The exam ranges from $36 – $63. Based on the results of the exam, your doctor may determine X-rays are needed. Depending on the views taken, X-rays range in price from $50 to $150.
On subsequent visits, the cost of an adjustment ranges from $29 to $36, depending on how many regions are adjusted.
Most insurance plans cover chiropractic care, although the level of coverage varies. Our helpful staff will pre-verify your insurance before your first visit and can discuss cost and payment options with you.
Your out-of-pocket cost will depend on the coverage provided by your insurance plan and the variety of services you receive during your visit.
Patients who choose to pay for their care directly (without insurance) at the time of service, qualify for a discounted rate. Patients who don’t have chiropractic benefits and pay for their care at time of service may qualify for a discounted rate.
