New Patient Paperwork
Kauffman Chiropractic offers our patient form(s) online so they can be completed in the convenience of your own home or office.
- All forms are PDF files. You will need AdobeReader® to view them.
- If you do not already have AdobeReader® installed on your computer,
Click Here to download. - Download the necessary form(s), print them out and fill in the required information.
- Bring the necessary form(s) to your appointment.
Kauffman Chiropractic is a preferred provider for the following insurance companies:
- Aetna
- Anthem / Blue Cross Blue Shield
- Blue Cross Blue Shield of Illinois
- BC Emergis
- Beech Street
- CCN
- Cigna
- First Health Network
- HFN
- Humana
- Indiana Health Network (IHN)
- Multiplan
- Private Health Care Systems (PHCS)
- Sagamore
- Unicare
- United Health Care
- Medicare
- Indiana Medicaid and many more!
Welcome Form
Pain Form
Privacy Form
Patient Consent Form
Doctor's Lien Form
Schedule an appointment at one of our locations below:
OUR LOCATIONS:
Merrillville
Crown Point
