Office Forms
Please see the list below for office forms which can be downloaded for you to fill out completely and bring in with you, for your appointment at healthworld.
- New Patient Form (Front)
- New Patient Form (Back)
- Application for Motor Vehicle No Fault Benefits (Page 1)
- Application for Motor Vehicle No Fault Benefits (Page 2)
- Verification of Treatment by attending physician or Other Provider of Health Service (Page 1)
- Verification of Treatment by attending physician or Other Provider of Health Service (Page 2)
- Assignment of Benefits Form
- Personal Injury (Back)
- Personal Injury (Front)
- Workers Compensation
HEALTHWORLD FINANCIAL POLICY AND RATES
1) Chiropractic Care:
a) We accept: MEDICARE, NO-FAULT (car accident cases), WORKER’S COMPENSATION (on the job injury cases ), BLUE/CROSS-BLUE SHIELD, AETNA, UNITED HEALTHCARE, CIGNA and many others both in or out of network.
b) Just fax: your name, date of birth, and front and back sides of your insurance cards, both the primary and the secondary cards to: 1–914–683–8951 . We will call the insurance company and verify your insurance status, and try to call you back promptly with your current insurance status.
2) You are responsible for your deductible, co-insurance, and co-pay, which is typically taken care of at the time of your office visit.
3) Should you not have any insurance coverage, we accept: Cash, personal checks, business checks, bank checks, money orders, credit cards and debit cards.
4) All patients coming in to the office, or online for NUTRITION related services, are a: CASH ONLY status patient, as insurance company’s do NOT cover nutritional services, yet buy cialis super active.
5) For all CASH ONLY status patients: chiropractic, nutritional or otherwise, please just call us for rates, at: 1–914–683–1777. Thank you so very much.
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