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Advanced Chiropractic of Middletown Delaware offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic 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) or bring it with you to your appointment.

New to our office?

In this section you will find out what we need to help you become a new patient. Please click on the link below to download our new patient forms and fill them out prior to your initial examination as this can save time upon arrival.

New Patient Forms for Patients With  Insurance
New Patient Forms for Patients Without  Insurance

New Patient Forms for Automobile Accident
New Patient Forms for Workers Compensation Accident

If you are using your Major Medical Insurance or Medicare Insurance please bring the following:

  • State Issued Photo ID
  • Insurance Card
  • Emergency Contact Information
  • Previous Medical History (if available)
  • List of Current Medications
  • Name and Phone Number of your Primary Care Physician

Cash Rates Are Also Available

If this is an Auto Claim, Work Comp Claim or Personal Injury Claim in addition to those listed above, please bring the following:

  • Any information pertaining to your injury. Including, but not limited to the date of accident/injury, police reports, hospital notes..
  • Name and Number of the Insurance Company handling your claim
  • Name and Number of the claim adjustor associated with your claim
  • Name and Number of any attorney that may be representing you

Exclusive Offer

Sign up now for a free consultation!

THIS ---->https://advancedchirode.com/online-forms.html

Office Hours

Monday9:00 a.m.6:00 p.m.
Tuesday9:00 a.m.12:00 p.m.
Wednesday9:00 a.m.6:00 p.m.
Thursday9:00 a.m.6:00 p.m.
Friday9:00 a.m.12:00 p.m.
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
9:00 a.m. 9:00 a.m. 9:00 a.m. 9:00 a.m. 9:00 a.m. Emergencies Emergencies
6:00 p.m. 12:00 p.m. 6:00 p.m. 6:00 p.m. 12:00 p.m. Emergencies Emergencies

Dr. Richardson specializes in injury rehabilitation and recovery due to auto accidents, work related injuries and personal injuries as well as every day aches and pains. He also specializes in Whiplash, Carpal Tunnel Syndrome, Extremities, Headaches, Manipulation Under Anesthesia, Allergies and much, much more..

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