Decorah Chiropractic Center

405 College Drive, Decorah, Iowa    Phone: 382-0700

Dr. David Gehling, D.C.

New Patient Forms
Please bring completed forms to your first office visit.

New Patient Forms
Patient Responsibility Financial Agreement
Consent Form NOTICE OF PRIVACY PRACTIES
   

Medicare Patients
In addition to the New Patient Forms, please bring this completed form to your first appointment as well.

Advance Beneficiary Notice of Noncoverage (MEDICARE patients)
   
PLEASE NOTE: Printing the New Patient Forms requires the use of Adobe Acrobat Reader. Most computers already have this program installed. If you can not view the forms, you may need to download the program free of charge. Click here or the image below.

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