Online Forms
Freeport Family Chiropractic Clinic offers our patient form(s) online so they can be completed in the convenience of your own home or office.
- If you do not already have AdobeReader® installed on your computer, click here to download.
- Download the necessary form(s), print it out and fill in the required information.
- Fax us your printed and completed form(s) or bring it with you to your appointment.
Cash and Insurance Patients
Informed Consent for Chiropractic Treatment
Personal Injury Protection (PIP)
Informed Consent for Chiropractic Treatment
Policy on Insurance Assignment