Forms and Insurance

New Patient Forms

Prior to your first appointment, please fill out the new patient paperwork, linked below. The Adult Patients form can be submitted online. The Pediatric Patients form must be printed and brought to your first appointment.

HIPAA Form

Please review this HIPAA document prior to your first appointment. You'll have the chance to sign off and ask questions when you arrive.

Insurance and Cash Rate Options

Capital Chiropractic & Rehabilitation Center accepts many major insurance plans and also offers a cash rate to best accommodate patients’ access to whole-person wellness care.

To help you make the best choice about whether to use your insurance coverage or choose a cash rate for your care here, please use the contact details below to contact your provider. Ask them to verify how much coverage you have for chiropractic care, acupuncture/dry needling, soft tissue therapies, and nutritional counseling. Then record those details on our handy Insurance Verification Worksheet for your reference.

Questions? We’d love to help. Please complete the Insurance Verification Worksheet above and bring it with you to your appointment!

Major Insurance Companies’ Contact Information

Amerigroup

Health Partners

Medica

UnitedHealthcare

  • Website
  • Phone: Call the number on your Health Plan ID Card for the most direct service help.

Wellmark 

Cash Rate

We use The Wellness Group to offer a cash rate that simplifies and streamlines patient access to care. Patients who choose this option typically are uninsured, underinsured, or prefer the reliable, simple rates and full access to all of our clinic’s treatments. To learn more about this option, just ask at the front desk.