New Patient Forms
All patients:
Please fill out our paperwork in this secure portal. Please click on the button below labeled: "Complete Paperwork Here"
Referring Providers for Hyperbaric Oxygen:
If you are a provider referring a patient for hyperbaric oxygen, please use this form:
UHC/Optum:
Some UHC/Optum patients need to fill out an additional form for chiropractic care, if you are advised to fill out this form by our team, please click the link below:
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 Options
Capital Chiropractic & Rehabilitation Center accepts most major insurance plans and also offers a self-pay option 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 self-pay 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, physical therapy, acupuncture/dry needling, soft tissue therapies, and nutritional counseling. Then record those details on our Insurance Verification Worksheet for your reference.
Please share a copy of your findings with us to minimize surprises for all of us as you seek care here.
Questions? We'd love to help. Please complete the Insurance Verification Worksheet and bring it with you to your appointment!
Auto Accident Patients
To verify your insurance coverage for treatment, please use our Auto Insurance Verification Worksheet linked below.
Major Insurance Companies' Contact Information
Amerigroup
- Website
- Phone: 1-800-600-4441 (TTY: 711) (Toll Free)
Health Partners
- Website
- Phone: 1-800-883-2177 (Toll Free)
Medica
- Website
- Phone: 1-888-592-8211
(TTY: 711) (Toll Free)
UnitedHealthcare
- Website
- Phone: Call the number on your Health Plan ID Card for the most direct service help.
Wellmark
- Website
- Phone: 1-800-524-9242 (Toll Free)
Self-Pay Option
We use The Wellness Group to offer a self-pay option 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.