New Patient Paperwork

Auto Accident Paperwork : (Automobile Accidents/Worker’s Compensation/Slip & Falls)

Please remember to bring the following information on your first visit:

 Driver’s License

Automobile Insurance Card

Group Insurance Card

Accident Report

Date of Accident

Insurance Declaration Page (You will find this in your packet sent from your insurance company explaining your benefits.)

Attorney’s Name, Phone Number and Address

Claim Number from your Insurance Company

Claims Adjusters Name, Phone Number and Extension

Any Medical Records/ X-Rays/ MRI’s pertaining to the accident

All Paperwork Filled out & Signed

                                                                                                                                                                                                                                                                                                                                                              Cash & Group Insurance Paperwork: (Cash, BCBS, UHC, Cigna, Aetna, Medicare, etc.)

Please remember to bring the following information on your first visit:

 Driver’s License

Primary Insurance Card

Secondary Insurance Card (If applicable)

Any Medical Records/ X-Rays/ MRI’s pertaining to your complaint

All Paperwork Filled out & Signed