Fees, Forms & Policies

It is my belief that anyone can benefit from chiropractic care and I celebrate the diversity of reasons for seeking out this form of healing. During your first visit we will meet for about an hour to discuss your reasons and goals for seeking chiropractic care, your history, and for you to ask questions and to learn more about chiropractic. 

We routinely mail a health history form to you before your first appointment so that you can fill it out ahead of time. You may also print that form from the link below.

Health History Questionnaire: Health History RiverSide Chiropractic

Child and Youth Health History Questionnaire: Child and Youth History

Statement of Purpose: Statement of Purpose RiverSide.pages

Notice of Privacy Practices: HIIPA Notice

Insurance Policy:

We are able to bill BCBS, Cigna, Medicaid and Medicare health insurance directly. Please notify us prior to your first appointment if you would like us to bill your insurance.

Please Note:

Neither Medicaid nor Medicare will pay for chiropractic exams and yet it is required that an initial exam is done before beginning treatment. You will be charged an out of pocket fee on your first appointment for the exam if you have Medicaid or Medicare insurance. Usually this fee does not exceed $80. For most individuals with Medicaid insurance, the fee is $60.

Most Medicare plans do not cover the portion of the chiropractic work that I do that addresses your extremities and soft tissue. There is therefore typically an out of pocket charge of $20 per visit to cover this portion of the service. If you have medicaid insurance as well as medicare then this fee is waived.

Fees for services if payment is received on the day of service:

Initial Chiropractic Exam and Adjustment:  $90 

Chiropractic Adjustment/Routine Office Visit:  $45

Zero Balancing session (45 min): $75 (this service is not covered by insurance)


Cancellation Policy:

Please call us at 262-6097 to cancel or change an appointment.

An appointment that is missed without contacting us or appointments that are repeatedly cancelled with less than 24-hours notice will result in a $40 fee.

Exceptions are gladly made for extenuating circumstances.

Please note that your insurance cannot be billed for a missed appointment.

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