[ GIF (118K) | PDF (210K) ]
|
[ GIF (142K) | PDF (206K) ]
|
[ GIF (172K) | PDF (272K) ]
|
|
Please fill these two forms if you are paying by cash
or don't have managed care plans for coverage.
|
Please fill this form if you have chiropractic coverage
thru American Specialty Health Plan.
|
[ GIF (32K) | PDF (81K) ]
|
[ GIF (22K) | PDF (36K) ]
|
Supportive Care:
Please fill this supportive care form
to help us keep track of your progress.
|
Designation of Personal Chiropractor:
Complete this form and give it to your HR staff at
work. If you ever get injured on the job you'll be able come to Dr. Snider
right away. Without this form your employer or the work. comp. insurance
company might try to limit your access to treatment by saying they "control
medical care for the first 30 days" (even this rule is not entirely true).
As most people know, the sooner you begin your care, the faster you heal.
The ability to be checked right after an injury is very crucial to a good
recovery.
|
|
Not sure? Just call the office
at (408) 736-7777
for direction on which form to complete.
|