Montpelier Family Chiropractic

Before your first appointment, please take a moment to download these forms. You can bring them with you or email them to us.

Microsoft Word Format	Adobe Reader (PDF) Format

New Patient Packet	Patient and Insurance Information
	Patient Intake Form
	Informed Consent to Chiropractic Treatment
	HIPAA Acknowledgement
	Patient Privacy Notice
Additional forms If you see your insurance company listed below, please download the forms associated with it and bring them to your appointment. All Insurance Companies (except United HealthCare) Neck Index Lower Back Index
United Healthcare *Patient Survey Form* *(complete bottom portion)* *UHC Back Index* *UHC Neck Index*	Anthem Healthkeepers *Initial Health Status Form* *Patient Progress Form* *(established patients)*

It is estimated that about 27 million Americans visit doctors of chiropractic each year, and millions more receive chiropractic care throughout the rest of the world. Chiropractic is the third largest primary health care field (after medicine and dentistry) and D.C.s are licensed in all 50 states as well as many foreign countries. It is a highly scientific approach to health care which has been proven effective in numerous research studies.

But don't take our word for it...ask someone who has benefited from Chiropractic care about the change it has made in their lives!