Optimum Health Forms:

For All New Patients:
Thank you for trusting our office for your healthcare needs. You may click on the following links to open and print our new patient forms. Please complete as accurately as possible including a signature. You must also bring in an insurance card and valid driver’s license with you on the day of your appointment.

For timely processing of benefit information, please fax a copy of front and back of your insurance card along with a copy of your driver’s license to our verification department at (678) 730-4379.

New Patient Forms:

• Patient and Insurance Information
• Health History
• Wellness Survey
  
• Consent and Authorizations
  
• HIPAA POLICY

For Automobile Accident Patients:
Please complete the required new patient forms above and the Auto Accident Injury Questionnaire. Please also follow the instructions above for verifying health insurance benefits prior to your appointment. Acceptable forms of payment are - Health Insurance - Medical Payments Insurance (Auto Policy) - Attorney Lien. We currently do not accept third party liens.

Please also bring with you on the day of your appointment the following applicable items:

Drivers License
Health Insurance Card
Accident Report
Auto Insurance Info (your vehicle)
Med-Pay Benefits
Attorney Contact Information

Additional Forms -Auto Injury Patients Only

Auto Accident - Injury Questionnaire

This is not a secured form of communication and any submissions made on my behalf are at my own guise and not the responsibility of Optimum Health.

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Frequently Asked Questions:

What Will My Complimentary Consultation Include?
One Free Massage! You will also receive a one-on-one consultation with our chiropractic doctor to determine whether you are a candidate for treatment. During this consultation you may also have questions answered about your specific ailments or about how integrated treatment can benefit you.

How Should I Prepare for My Appointment?
Please download and complete new patient forms in advance and fax to our office prior to arriving for your appointment . For Insurance patients please also fax a copy of front and back of your insurance card along with your driver’s license. Automobile injury patients will require some additional items. For a list of these items, please click here.

If you have been previously treated for a specific injury, pain, or condition, you will want to obtain your medical records to share with our doctors. Recent X-Rays, MRI’s or other diagnostic reports may expedite the diagnostic process.

How Long Will My Appointment Take?
Your initial visit should last about one hour.

Do You Accept My Insurance? How Much Will it Cost?
Yes, we accept most insurance plans. We will gladly verify and discuss your benefits as it relates to your care during your consultation. If you do not have health insurance, many affordable self-pay options are also available. Our staff will discuss these plans as well as other health care financing options available to you at your consultation. We accept care credit for financing through www.carecredit.com.

How Long Will I Need Care?
Every patient is different. However, once you are evaluated, a treatment plan is designed to meet your specific needs. The length of your care directly relates to the severity of your injury or the duration of your health issues. Our team integrated approach will return you to health in the shortest time possible.

Is Chiropractic Safe?
Yes, Chiropractic’s record of safety and effectiveness is unmatched in healthcare today. Of the nearly million adjustments given every day in this country, complications are exceedingly rare. To learn more about the record of chiropractic, please visit the website at www.chiropracticissafe.org