Holland Chiropractic offers our patient form(s) online so they can be completed in the convenience of your own home or office.
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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.
New Patient Health History Form - Required
This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!
Questions about your bill
Holland Chiropractic believes in the value of wellness care for you and your family and have maintained a pricing structure that allows care for all budgets. Our office participates in most insurance programs. We also accept auto accident and workers compensation cases. For patients who have little or no chiropractic insurance coverage, flexible payment programs can be arranged. To learn more about our payment options for chiropractic and wellness care, you can call our office directly.
Most insurance plans are accepted at our office. We accept auto accident, workers compensation, personal injury and most health insurance plans, including Medicare. Since there are so many plans and coverage varies widely, please call us to find out if your plan covers care in our office. Our staff will verify and explain your benefits before treatment, at no charge.
For patients who have little or no chiropractic insurance coverage, flexible payment programs can be arranged. If you have no insurance or do not have chiropractic benefits there is still a way for you to receive the care you need. Many patients pay directly for care, as they discover chiropractic to be extremely cost-effective and affordable.