NEW PATIENT PAPERWORK

Below you will find the paperwork necessary for your first visit with Dr. Pritchard. You can download them and fill them out right on your computer. When you're finished, simply print them and bring them with you on your initial visit.

Filling this out honestly and completely will ensure the greatest outcomes for your care.

Please select the form which best suits your needs:

"Standard" for our cash or major medical insurance patients

"Child" for anyone bringing in a child under the age of 14

"Personal Injury" for our motor vehicle accident or others injured in a situation where a 3rd party insurance or attorney is involved.

"Work Injury" for our patients that were injured in a work incident and a 3rd party payer is involved.

Download New Patient Paperwork - STANDARD PATIENTS

Download New Patient Paperwork - CHILD PATIENTS

Download New Patient Paperwork - PERSONAL INJURY

Download New Patient Paperwork - WORK INJURY

NEW PATIENT SPECIAL

  • No Waiting For Your Appointments
  • We Handle All Your Insurance
  • We Get The RESULTS You Want
  • We Have The Experience Necessary
  • We Have Affordable Cash & Family Plans
  • If We Can't Help You, We Will Refer You to Someone Who Can
5579 N Hamilton Rd, Columbus, OH 43230, USA

Potent Chiropractic

5579 N Hamilton Rd

Columbus, OH 43230

P: (614) 934-5078

F: (614) 973-7999

CALL TODAY: (614) 934-5078

Dr. Pritchard's Hours

Monday: 9:30 - 12:00 & 3:00 - 6:00

Tuesday: 9:30 - 12:00 & 3:00 - 6:00

Wednesday: 9:30 - 12:00 & 3:00 - 6:00

Thursday: 9:30 - 12:00 & 3:00 - 6:00

Friday: 9:30 - 12:00 & 3:00 - 6:00

Saturday: 9:30 - 10:30

Copyright 2023 | Potent Chiropractic & Dr. Tylor Pritchard | Privacy Policy | Healthcare Disclaimer | HIPAA Policy | Terms of Service | Accessibility