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Medical and Insurance Forms
To best serve our patients we need accurate information on which to base our course of treatment. We are providing a number of our forms here for your convenience. They open in PDF format and can easily be printed and completed. If you do not have the free Adobe Reader software on your computer click the button here to download and install it.
  New Patient Forms
New Patient Form Package Opens in Adobe Reader PDF
  Four page document to complete and review for all new patients.
Pregnancy Disclaimer Opens in Adobe Reader PDF
  This is required to be completed by our female patients
Consent to treat a minor Opens in Adobe Reader PDF
  Parents or guardians need to authorize us to treat minor children.
  New Patient Auto Accident
New Patient due to Auto Accident Forms Package Opens in Adobe Reader PDF
  Three documents to complete and/or review before your appointment.
  Medicare Forms
Medicare Forms Package Opens in Adobe Reader PDF
 

Four documents to complete and/or review before your appointment.

  Workers Compensation Forms

Workers Comp Patient History Opens in Adobe Reader PDF
  Four documents to complete and/or review before your appointment.
 

 

 
Copyright 2007 Gentner Chiropractic Center, All Rights Reserved.

 

 
 
 

PRODUCTS

Support Pillows
Need a pillow that gently supports your head? Our Fiber Support Pillow is just the one for you. It's 100% polyester and washable.

Cool Aching Muscles
BioFreeze now comes in an easy to apply 3 oz Roll-On. This great product has an herbal extract for fast-acting, deep penetrating, longer-lasting pain relief. Perfect for those days when you overdue your exercise routine.

OUR TEAM

CHIROPRACTIC FACTS
OUR LOCATION
  13708 Madison Avenue
Lakewood, OH 44107
216-221-2008