Patient Resources

Downloadable Forms

Download, print, and bring to your visit to save time:

$

New Patient Intake Form

$

Pain Diagram Form

$

HIPAA Consent Form

SoftWave Forms

Only needed for patients receiving SoftWave Therapy:

$

New Patient Intake Form

$

SoftWave Intake Form

$

SoftWave Consent Form

Billing

Insurance Information

At the Albino Chiropractic Health & Wellness Center, we accept auto accidents, workers’ compensation, personal injury, Medicare, and most major insurance plans.

If your insurance plan requires you to pay a co-payment, co-insurance, and/or a deductible, you will need to pay at the time of your visit. For your convenience we accept cash, checks, Visa, MasterCard, Discover, and American Express.

As a courtesy to our patients, we will bill any commercial insurance carrier assigned, but you remain financially responsible for all services furnished. Any outstanding balance after 60 days from the date of invoice is considered in default.

If you have a question related to your bill or insurance, please contact our office manager at (203) 574-4400, ext 103.

What to Expect

Whether you’re a first time or returning patient, there are a few key steps you can take to ensure you get the most out of your visit.

BEFORE Your Visit

  • Schedule an appointment by filling out the contact form on the website, or by calling the office at (203) 574-4400
  • Download, print, and fill out any necessary forms
  • Begin gathering the materials described in the next section

DURING Your Visit

Make sure to bring the following with you to your first visit, or if any of the following information has changed:

  • Your completed paperwork
  • Insurance cards
  • A photo ID or driver’s license
  • A co-pay if your insurance requires one
  • Any applicable X-rays, MRIs, or other medical records
  • A list of your current medications
  • Wear loose, comfortable clothing or bring a pair of shorts

AFTER Your Visit

  • Drink plenty of water
  • Keep moving, but avoid strenuous activity or sudden, sharp movements
  • Follow instructions for applying heat/cold as outlined by the doctor
  • Eat a healthy, nutritious meal
  • Pay attention to any changes in pain levels or sensations around the problem area
  • Follow up with other doctors or Albino Chiropractic Center as needed

Get started on the path to Better Health.

Want to set up an appointment or get more information? Fill out the form below and a member of our staff will be in touch with next steps. Please do not submit any Protected Health Information (PHI) through this form.

Office

1052 Chase Parkway
Waterbury, CT 06708

Monday : 7:30am – 6pm

Tuesday : 7:30am – 5pm

Wednesday : 7:30am – 6pm

Thursday : 7:30am – 2pm

Friday : 7:30am – 6pm

Saturday : Appointment Only

Sunday : Closed