New Patients
We are continually accepting new patients! We accept all forms of
insurance, and we will gladly verify* and file your insurance for you.
We are in-network on most major insurance plans. We accept cash, check
or credit card as payment for all patient financial responsibilities.
Please contact us today to schedule your INITIAL CONSULTATION!
To
expedite your initial visit, the New Patient Paperwork is available for
download. Please click on the appropriate link to download the file.
If you have any questions, please do not hesitate to give us a call.
Initial Paperwork (General Patient) PDF
Initial Paperwork (Minors) PDF
Initial Paperwork (Auto Accident/PI Claim) PDF
Initial Paperwork (Medicare Patients) PDF
If United Healthcare, Great West or Secure Horizons is your primary insurance carrier, please also download the following form:
ACN Notification Form PDF
Additional Forms:
Records Transfer Request PDF
Notice of Privacy Practices PDF
Public Interest Information PDF
*
Verification of benefits is not a guarantee of coverage or payment.
The Mobile Chiro will make every attempt to verify your policy's
Chiropractic benefits, but it must be understood that ultimately you are
responsible for your account. You may want to call your insurance
company to confirm the information The Mobile Chiro was given.
972-86-SPINE / 972-867-7463 Dallas, TX 75248