New Patient Center
Welcome to the Jenkins Family Chiropractic New Patient Center!
Jenkins Family Chiropractic is a state of the art office with affordable chiropractic care. We offer the same level of care and
concern to you that we give to our own family. There are no long patient intake forms to fill out, only three sheets of paper
and you are ready for your spinal exam…that’s it. Call us at 203-877-4198 and Gabbie will get you started.
New Patient Intake Form
We recognize that your time is valuable and so we have simplified and expedited the intake
process for new patients. Please click on the link here to download and print your New Patient
Intake Form and complete them at your convenience, prior to your visit. This will shorten the time
necessary for your initial visit and help us to maintain an office environment will minimal wait.
Auto Accident Intake Form
If you have been involved in a motor vehicle accident we have a separate form for you
to fill out in order for us to provide you with the best service possible to return you to
optimal function. Please click on the link below to download and print this form in the
convenience of you own home to expedite your initial visit at Jenkins Family Chiropractic.
Insurance Verification Form
Would you like to find out what your insurance benefits for Chiropractic care are prior to coming in? Just print this
form and call the member services telephone number on the back of your insurance card. We have designed a
form that will help you ask all the necessary questions to determine if and what your insurance will contribute to
your care. Remember, you do not need insurance to see us at Jenkins Family Chiropractic and many of our
patients elect not to submit to insurance because they often save money with our custom care plans.