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New York Chiropractic Associates offers our patient forms online, so you can complete them in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) to 212-861-4769 or bring it with you to your appointment.


Required for New Patients

Patient Health Record

Office Policy

Required for Former Patients

Update Form


Insurance Paperwork

Required for Oxford, United Health Care, and Aetna plans managed by ACN

**Please fill out the bottom portion of the patient summary form**

Patient Summary

Neck Index

Back Index

Required for BCBS and Cigna plans managed by American Specialty Health Network (ASHN)

Initial Health Status

Patient Progress

Exclusive Offer

THIS ---->https://drcorygold.chiromatrixbase.com/online-forms.html

Office Hours

Day
Monday7:45 am6:00 pm
Tuesday1:00 pm6:00 pm
Wednesday7:45 am6:00 pm
Thursday1:00 pm6:00 pm
Friday7:45 am1:00 pm
SaturdayShabbatShalom
SundayClosedClosed
Day
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
7:45 am 1:00 pm 7:45 am 1:00 pm 7:45 am Shabbat Closed
6:00 pm 6:00 pm 6:00 pm 6:00 pm 1:00 pm Shalom Closed

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