Cold Spring Chiropractic

Charles A. Kinzer, D.C.

Patient Introduction Forms to be completed by New Patients

If you are a new patient please complete one of the following forms by clicking on it, printing it, and filling it out.

Please bring the completed form with you when you come to our clinic.

If you are Self Pay use this form, click Self Pay

If you have Health Insurance use this form. click Health Insurance

If you have Auto Insurance or Personal Injury Insurance, use this form. click Auto or Personal Injury Insurance

If you have Workers Compensation use this form. click Workers Compensation