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Credit Card Authorization Form

Credit Card Authorization Form

Credit Card Authorization Form

$2.60

Daily Checkout Sheet

Daily Checkout Sheet

Daily Checkout Sheet

$3.50

Detailed Exam Form

Detailed Exam Form

Detailed Exam Form

$3.50

Detailed Pediatric Exam Form

Detailed Pediatric Exam Form

Detailed Pediatric Exam Form

$2.60

Doc Permission Slip & Return to Work / School

Doc Permission Slip & Return to Work / School

Doc Permission Slip & Return to Work / School

$5.30

Explanation of Medicare Benefits for Chiropractic Services

Explanation of Medicare Benefits for Chiropractic Services

Explanation of Medicare Benefits for Chiropractic Services

$6.00

Fax Cover Sheet

Fax Cover Sheet

Fax Cover Sheet

$2.60

Financial Hardship Payment Agreement

Financial Hardship Payment Agreement

Financial Hardship Payment Agreement

$6.00

First Experience Coupons (3 per page)

First Experience Coupons (3 per page)

First Experience Coupons (3 per page)

$8.00

Fit Ball Exercises

Fit Ball Exercises

Fit Ball Exercises

$5.50

General Insurance Opt Out Form

General Insurance Opt Out Form

General Insurance Opt Out Form

$6.00

Got Subluxation Survey

Got Subluxation Survey

Got Subluxation Survey

$5.30

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