New to SkyeChiropractic.com! All our patient forms are now online so you can come to your appointments prepared! We have forms for both our new patients and established patients concerning first appointments, new injuries, and other patient needs. Please find the information below that pertains to you and print off the needed pages.
Please bring your photo ID and any applicable insurance cards along with the three documents below.
- Confidential Patient Information
- HIPPA Privacy Notice
- Financial Policy
- Consent to Treat Form
- Consent to Treat a Minor (if applicable)
- Non-Covered Services
Personal Injury (Auto Accident)/ Worker's Compensation Claim Injuries:
If this is your first visit to our office please complete the Welcome Form and HIPPA Privacy Notice listed in the New Patient section as well as all paperwork below. Bring all forms along with a Photo ID to your first appointment with Dr. Skye. If your are an established patient with a new injury, please complete all paperwork below as well as the Patient Update form listed in Additional Patient Information and bring these items to your next appointment.
- Automobile Crash Questionnaire
- Accident/Injury Questionnaire
- PI/WC Contact Form
- PI/WC Accident Form Back
- PI/WC Contact Form
- Worker's Compensation Financial PolicyOR
- Personal Injury Financial Policy
- Doctor's Lien (for PI cases who have an attorney)
- Irrevocable Assignment (if directed by office manager)
- 3rd Party PI Agreement (for cases using 3rd party insurance)
Additional Patient Forms:
- Information Update (for change in name, address, or phone numbers)
- Patient Update "What's New" (please complete if your last visit was greater than 12 months ago or you have a new injury)
- Authorization for Release of X-Rays and Records (please complete if we are requesting records on your behalf from another facility or doctor)
- Authorization for Release of Information (please complete if your records from our office are to be sent to another doctor or facility, etc)
- Refund Request (if you currently have a credit and would like a refund, please fax or mail to our office)
- If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download it for free.
- Click on the necessary form, print it out and fill in the required information.
- Fax us your printed and completed forms or bring them with you to your appointment and save time on your visit!