Deutsch Chiropractic: Patient Forms

FORMS

If you are a new patient at Deutsch Chiropractic, completion of the
patient information and health questionnaire forms (below) will allow us to get you right in to see the doctor without any waiting to complete paperwork in the office.

Click on the links below, the forms will open up in Adobe Acrobat Reader, print out the forms, fill them out to the best of your knowledge, and bring them in with you on your first visit.

Note: The forms are formatted in Adobe Acrobat. In order to view them you will need Adobe Acrobat Reader installed on your computer. If you do not have Adobe Acrobat Reader you can click here to download it FREE.

If you do not have access to a printer you may fill out the forms when you arrive to Deutsch Chiropractic.

Click Here to Download the Patient Information Form
Click Here to Download the Health Questionnaire Form

GROUP OR INDIVIDUAL INSURANCE

We attempt to take out as much of the "insurance hassle" as possible for you. We'll happily telephone your insurance company to verify your coverage benefits. We're participating providers for nearly all local insurance companies including Blue Cross, Dakota Care, Sioux Valley, Midlands Choice, etc. If you have any questions at all, please do not hesitate to ask. Our insurance clerk has years of experience and will be happy to assist you.

PATIENTS WITHOUT INSURANCE

An increasing number of patients do not have insurance, or have plans with limited coverage, such as catastrophic policies. We have several plans so those patients may receive complete care without undue financial difficulty. Of course we are always happy to accept cash, your personal check, MasterCard, Visa or Discover cards.

"ON THE JOB" INJURY (Worker’s Compensation)

If you are injured on the job and are entitled to care covered by Worker's Compensation insurance, we'll bill your worker's compensation carrier for services your receive. State law requires you to notify your employer of your injury within 72 hours. Please inform our insurance clerk if you've been hurt while working on the job so we can complete the necessary paperwork.

PERSONAL INJURY OR AUTOMOBILE ACCIDENTS

If your care and treatment is due to injuries you receive in a car accident we'll bill the auto insurance company for all services rendered. Provided you have sufficient benefits, services may be fully covered. Please notify our insurance department if you have an attorney is representing you.

MEDICARE

For the past 25 years we've been participating providers with Medicare. In a chiropractor's office, Medicare only pays for manipulation of the spine (and no other services). Medicare requires us to fully explain to all Medicare patients that the only service they pay in a chiropractor's office is spinal manipulation. We'll make sure you are completely aware and fully informed!