Online Forms
New York Chiropractic Associates offers our patient forms online, so you can complete them in the convenience of your own home or office.
- If you do not already have AdobeReader® installed on your computer, Click Here to download.
- Download the necessary form(s), print it out and fill in the required information.
- Fax us your printed and completed form(s) to 212-861-4769 or bring it with you to your appointment.
Required for New Patients
Required for Former Patients
Insurance Paperwork
Required for Oxford, United Health Care, and Aetna plans managed by ACN
**Please fill out the bottom portion of the patient summary form**
Required for BCBS and Cigna plans managed by American Specialty Health Network (ASHN)
Contact
New York Chiropractic Associates
1020 Park Avenue
New York, NY 10028
Get Directions
1020 Park Avenue
New York, NY 10028
Get Directions
- Phone: 212-249-6767
- Fax: 212-861-4769
- Email Us