Thank you for choosing
Core chiropractic center.
We look forward to treating you, and want to make the intake process as easy as possible for our patients.
Please bring the following with you to your initial visit:
Completed new patient paperwork
State issued photo ID
If you're using health insurance, please bring your current insurance card(s) (copies, handwritten info, photos, and virtual cards are not accepted). If you do not have your card with you at your initial visit you may be asked to reschedule.
Any medical records related to your treatment (X-rays, MRI's, office notes from another provider) etc.
If you are a Personal Injury patient, you will need to fill out the new patient paperwork as well as the Personal Injury paperwork. We will need your claim number, adjuster's name and phone number. date of accident, and the name of your attorney with phone number if any.
Co-pay's are due at the time of service. Services are to be paid in full unless otherwise arranged.
We accept; Visa, Mastercard, Discover, Cash and Personal Checks. We do not accept American Express at this time.
Please click and print the new patient form below.
Chiropractic and Massage patients use the New Patient Form.
Core Chiropractic Center adheres to the requirements outlined by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), as well as applicable Kentucky General Laws, which ensure the privacy and security of an individual's health information and promotes privacy and trust between patients and their health care providers. We have detailed policies and procedures in place to safeguard your rights to privacy and confidentiality. The Records Department can also provide information on how we protect your health information and how you may request you/your minor child's health information. As part of HIPAA requirements, all new patients seeing their health provider, upon their initial visit, are required to sign the Acknowledgement of Receipt of Privacy Notice form to indicate they have received the Notice of Privacy Practices. Our Notice of Privacy Practices describes how we the practice/provider may use or disclose your health information; your rights to access your health information and/or to request changes to your health information. You may also request a list of people or organizations that you did not authorize but who may have received your health information from us. You may view Core Chiropractic Center Notice of Privacy Practices here.