for Your Appointment at Lancaster Depew Chiropractic
Skip the paperwork in the office, and download our new patient forms!
Please print and fill out all forms pertaining to you, as they are mandatory for your insurance.
Empire/United Health Insurance:
All Other Insurances/Cash:
Motor Vehicle/ Personal Injury:
If you are experiencing Low back pain, please print and fill out the Low Back Pain Charts 1 & 2.
If you are having neck pain, please print and fill out the Neck Pain Chart.
If you are experiencing headache pain, please print and fill out the headache form.
If you having pain in all three areas, please print and fill out all 4 forms.