Patient Forms




Office Hours

Monday:
9:00 am - 1:00 pm
&
3:00 pm - 6:30 pm

Tuesday:
3:00 pm - 6:30 pm

Wednesday:
9:00 am - 1:00 pm
&
3:00 pm - 6:30 pm

Thursday:

3:00 pm - 6:30 pm

Friday:
9:00 am - 1:00 pm

Saturday:
Closed

Sunday:
Closed



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Chiropractic Clinics

As a courtesy to our future patients, we have made our new patient forms accessible on our website so that you can print and fill them out at your own convince before coming in for an initial visit.  This not only makes it more convenient for you, but it also allows us to be able to serve you more efficiently.  We look forward to serving you!

New Patient Application: click here:

Child/Adolescent Application: click here:    Please fill out for children under the age of 12.

Auto Accident Form: click here: If you were involved in an auto accident and are seeking treatment from our office, please download and fill out this form and bring it into the office with you on your initial visit.
 
Terms of Acceptance: click here

Payment Options: 

We are proud to be an In-Network Provider for the following insurance carriers...

                 

                      

 

    
            
      

In-Network Insurance Carriers Listing: 
        BlueCross BlueShield: including State Health Plan, Preferred Blue, Blue Choice
                                                           and Medicare Advantage.
        Medicare
      
  Aetna 
        Cigna
 
       United HealthCare
        MedCost
        Humana 
      
  South Carolina Medicaid: including Absolute Total Care, Select Health/First Choice,
                                                                  and
Blue Choice.
        Just to name a few...

More insurance companies are being added, so please contact us to see if yours is one of them.  Remember, most insurance companies do provide benefits for out of network doctors, so don't let this stop you from getting the care you need. 

   If you do not have insurance, don't worry, we still would love to serve you.  We have several payment options to best suit your needs.  Contact us today with any questions.            

  

CareCredit for Treatment and Care:
It’s something you’ve always wanted to do, but something else was always there to hold you back. Well, not anymore. We offer CareCredit, a card designed specifically for your healthcare needs. CareCredit can help you move forward with getting the procedure you’ve always wanted. With low minimum monthly payment options, no up-front costs and no prepayment penalties, you can get your procedure sooner. 

Your healthcare credit card:
CareCredit is the credit card exclusively for healthcare services.  With low monthly payments every time you use it, you can use your card over and over for follow-up appointments or different procedures. This means you don’t have to put your health on hold until you save up enough money. We give you the power to decide when it’s the right time for you.

With CareCredit, you can:
o    Get the treatment or procedure you want, when you want it
o    Enjoy low minimum monthly payments
o    Pay no up-front costs or pre-payment penalties
         

 Learn more by visiting CareCredit.com or contacting our office.
Ready to apply? Apply online for your CareCredit card today.

New patients are currently being accepted.

Call for an appointment

Contour Chiropractic
1728 Old York Road
York, SC 29745
(803) 818-5377
info@contourchiropractic.com

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