Complete Health of Lawrenceville offers our patient form(s) online so they can be completed in the convenience of your own home or office.
- Download the necessary form(s), print out, and fill in the required information
- Fax your completed form(s) to (609) 912-1908 or bring with you to your appointment
For your first appointment, please bring:
- Your New Patient paperwork
- Insurance Card(s)
- Drivers License or other Photo ID
- Previous Imaging (X-rays, MRIs, CT Scans, etc.)
- Previous Testing (EMG, Nerve Conduction Test, etc.)
Required Chiropractic Forms:
- Patient Intake Form
- Informed Consent for Chiropractic Spinal Manipulation and Treatment
- Patient Acknowledgement and Receipt of HIPAA Form
- HIPAA Policy (please read before signing the Patient Acknowledgement and Receipt of HIPAA Form)
*Please note, if you are a minor under the age of 18, a parent or guardian must also sign the Consent for Treatment and HIPAA forms.
Required Physical Therapy Forms:
- Patient Intake Form
- Patient Acknowledgement and Receipt of HIPAA Form
- HIPAA Policy (please read before signing the Patient Acknowledgement and Receipt of HIPAA Form)
*Please note, if you are a minor under the age of 18, a parent or guardian must also sign the Consent for Treatment and HIPAA forms.
Required Acupuncture Forms:
- Acupuncture Patient Intake Form
- Patient Intake Form (Please complete page 1 if only coming in for acupuncture. Please complete all pages if you will be utilizing services other than acupuncture in the future.)
- Acupuncture Informed Consent
- Patient Acknowledgement and Receipt of HIPAA Form
- HIPAA Policy (please read before signing the Patient Acknowledgement and Receipt of HIPAA Form)
*Please note, if you are a minor under the age of 18, a parent or guardian must also sign the Consent for Treatment and HIPAA forms.
Required Liability Insurance Forms:
- Workers Comp Form
- Auto Accidents Form
- Neck Disability Index (if applicable)
- Low Bask Disability Questionaire (if applicable)
For Motor Vehicle Accidents, please also bring:
- Auto Insurance Card
- Declarations Page (Usually the first page of your policy, states your auto insurance benefits)
- Claim Correspondence (Claim Number, Adjuster, and Adjuster's Contact Information)
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