Feel free to download the forms to have them completed before your first visit.
GET THE 9 PAGE INTAKE FORM here. Print it and bring it to the exam appointment.
*PAYMENT: Full payment is expected at time of Exam/Treatment. Cash and checks are accepted for payment at this time. We DO NOT accept credit cards, insurance or medicare/medicaid at this time. We are VA approved.
Download the facial form here
For more information and questions about our services, reach out to us.
(Fort Wayne NE Office) 6049 E State Blvd, Fort Wayne, IN 46815, USA | (Decatur, IN Office) 824 S 11th St Decatur, IN 46733
Feel free to download the .pdf forms to have them completed prior to your first visit. If you do not have Adobe Reader, you can download it for free from Adobe.com
Press this link for the 9 page intake form. Print it and bring it to the exam appointment.