Complete Health of Lawrenceville offers patient forms online so they can be completed in the convenience of your own home or office.  

Please follow the directions below to complete your New Patient Paperwork

For your First Appointment, please bring:

• Your New Patient Paperwork - Intake Form, HIPAA, Consent (if applicable) - *Intake Form can be completed electronically.  Please see below!
• Insurance Card(s)
• Drivers License or other Photo ID
• Previous Imaging (X-rays, MRIs, CT Scans, etc.)
• Previous Testing (EMG, Nerve Conduction Test, etc.)

If you are unable to complete paperwork prior to your appointment, please arrive at the office 20 minutes before your appointment time. 

For Motor Vehicle Accident Patients, please also bring:

• Auto Insurance Card
• Declarations Page (Usually the first page of your policy stating your auto insurance benefits)
• Any Claim Correspondence (Claim Number, Adjuster, and Adjuster's Contact Information)
• Contact Information for your Attorney (if applicable)

If you are unable to complete paperwork prior to your appointment, please arrive at the office 30 minutes before to your appointment time. 

Required Chiropractic Forms:

• Patient Intake Form - Can be submitted electronically *PLEASE USE A COMPUTER*
• 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 - Can be submitted electronically *PLEASE USE A COMPUTER*
• 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  HIPAA form.

Required Acupuncture Forms: ***Please see below for additional directions

• Patient Intake Form - Can be submitted electronically *PLEASE USE A COMPUTER*
• Acupuncture Supplement Intake Form ***
• Acupuncture Consent 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.

***IMPORTANT: Please print and complete these documents before coming in for your appointment.  If possible, the acupuncturists would appreciate receiving the documents prior to your appointment.  These can be emailed to [email protected] or they can also be faxed to (609) 912-1908.  Additionally, the acupuncturists need every new patient to email tongue pictures prior to your appointment.  Please take one photo of the top of your tongue, relaxed and out of your mouth.  Please take another photo of the underside of your tongue (as if you were licking the roof of your mouth).  Yes, these are an important part of the Acupuncture evaluation.  Please email these photos, with your Patient Name in the Subject line, to [email protected] prior to your appointment.  

Required Nutrition Counseling Forms:

Required Liability Insurance Forms:

• Workers Comp Form
• Auto Accidents Form
• Neck Disability Index (if applicable)
• Low Back Disability Questionaire (if applicable)

If you do not already have AdobeReader® installed on your computer, Click Here to download.

Download the Free AdobeReader®

Updated 12/31/2020