Forms and Insurance

New Patient Forms

Please complete and submit new patient forms prior to your first appointment. Once you arrive for your first appointment, there will be a few documents for you to sign in addition to this online document. If you are not able to complete the online form in advance, please arrive 10-15 minutes early to complete all forms.

Please note: Our online forms are compatible with iPhones and desktop computers, but not Android phones.

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 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, 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 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 

Self-Pay

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.