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Notice to Our Patients with Insurance Coverage As a courtesy to you, we will call your insurance and ask them what, if any, chiropractic coverage you may have at our office. Please be advised that there have been instances when the insurance company did not give us correct or complete information. One problem has been that we were not informed that your company requires a referral from your doctor before your chiropractic coverage is allowed. To avoid any problems that may arise, we request that you also call your insurance and verify your coverage. We require that this form be completed before we can bill your insurance. If it is discovered that your insurance company has given us incorrect information, and that you do not have coverage, you are responsible for paying for your care. PDF Forms:
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