New Patient Paperwork

Kauffman Chiropractic offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • All forms are PDF files. You will need AdobeReader® to view them.
  • If you do not already have AdobeReader® installed on your computer,
    Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Bring the necessary form(s) to your appointment.

Kauffman Chiropractic is a preferred provider for the following insurance companies:

  • Aetna
  • Anthem / Blue Cross Blue Shield
  • Blue Cross Blue Shield of Illinois
  • BC Emergis
  • Beech Street
  • CCN
  • Cigna
  • First Health Network
  • HFN
  • Humana
  • Indiana Health Network (IHN)
  • Multiplan
  • Private Health Care Systems (PHCS)
  • Sagamore
  • Unicare
  • United Health Care
  • Medicare
  • Indiana Medicaid and many more!

Patient Consent Form

Doctor's Lien Form

OUR LOCATIONS:

Merrillville

Crown Point

Kauffman Chiropractic in Merrillville and Crown Point