Patient Forms

PATIENT FORMS

Patient Forms via OnPatient
The easy way to complete your new patient intake forms! OnPatient is an online patient portal connecting you with Premiere Spine & Sport. Here's how it works:

Once you have an appointment scheduled with a Premiere Spine & Sport clinician, we will send you an email inviting you to connect with us via OnPatient.  Open the email and click the link to sign up.  Follow the prompts to set up your account access.

When logged in, your appointment will be displayed on the homepage.  To access the new patient forms, click the "Check In" button.  The next screen contains the intake forms and is labeled "Onboarding forms." Go through and complete all sections to the best of your ability. Make sure to read through and sign the consent forms at the end, then click "I'm Done" to complete the online forms.
Can't Complete the Forms Beforehand?
In the event that you do not have the ability to fill out the intake forms online, we ask that you arrive 15 minutes prior to your appointment time so you can fill them out in the office.  
Additional Forms

Additional steps may be required if any of the following apply to you:

Auto Accidents (please arrive 15 minutes early)
If your appointment is for treating injuries sustained from an auto accident, we will need to collect some additional details.  We have an additional form to be completed in the office, which provides us with the specific details about the accident, as well as details about alternative auto insurance options or attorney representation you may have retained.  Please arrive 15 minutes early for your appointment.  
Medicare Patients
Medicare coverage for chiropractic is limited to spinal adjustments.  Any other service(s) provided will not be covered by Medicare and will be an additional out of pocket expense to the patient.  All Medicare patients are required to review and sign the Explanation of Non-Covered Chiropractic Services, to acknowledge that they understand which services Medicare will and will not cover.
Not sure which forms apply to you?  
Please call the office for assistance (408) 448-4445 
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