Brand-new patients are always welcome
From infants to the elderly, Rosa Chiropractic Center is always accepting new patients. From back and neck paint to other muscle groups, we use only the latest techniques to make your life complete once again.
A pleasant first visit to our practice
Our hope is to make your visit as pleasant and convenient as possible, which is why we ask you to fill out these forms before you come in. Just click on the links on this page and fill them out at your leisure. Bring them to your first visit or even fax them.
Forms to print and make your life easier
- Patient Intake Form
- Auto Accident Form
- Worker's Compensation Form
- Letter of Protection
- Record Release Authorization
- Discolosure Form
- Consent To Treatment of Minor Child
- Print or Fax them over or bring to your first appointment
Payment Options we accept:
- BCBS
- AETNA
- Cash
Personal Injury Cases we accept:
- Motor Vehicle - with attorney or with medpay
- Workers Compensation
Call and schedule your first appointment!