Telehealth visits beginning soon!!!!!!
Below are Fairfield Spine and Rehab Center, LLC new patient forms. Prior to your first appointment, please print off, read, and fill out each of these forms to expedite your wait time in the office. The last form(Insurance Verification) is provided for you to call your insurance company and verify how much chiropractic care and what kind they will cover. Please, do call for your peace of mind and an easy transition to your treatment plan with no added stress.
Application for Care (pdf)Download
Health History pg. 1 (pdf)Download
Informed Consent (pdf)Download
Financial Policy (pdf)Download
Insurance Verification (pdf)Download
Complaint Form (docx)Download
ROS Form (docx)Download
Telehealt Packet (pdf)Download