Forms

Click on the icons to download the form that you need.
Intake Form (pdf):

Consent Form (pdf):

Accident Questionnaire (pdf):

Patient Health Questionnaire (pdf):

Insurance

At Synergy Chiropractic and Wellness we are providers for all major insurances, including, but not limited to, Blue Cross/Blue Shield, Medica, United Health Care, Health Partners, Medicare, U-Care and more. We also cover automobile accident injuries and worker’s compensation claims with no co-pay or deductible. We are also happy to process your claims for you.

We also understand that many of you have high deductible plans and many employers have switched to HSA’s or Health Savings Accounts. If you prefer to pay cash for your health care, we offer several different discount or membership options. Just ask our friendly staff when you call or come in and we will be happy to assist you with your questions.