Documents for Our New Patients

Documents for Our New Patients

Thank you for your interest in Community Wellness Collaborative’s Adams Ave Center!

In order to process your appointment requests, we will first need each patient to complete their:
New Patient Medical History form.  

Due to COVID-19, we are no longer allowing patients to complete these in person.  They are fillable PDF’s and require Adobe PDF to complete.  If you do not have this, please download it here or a mobile version is available from the App Store or Google Play.

Please save the forms to your device first, and then fill them out, and save again.  Then send them to us either via email or upload through our secure portal.  One of our associates can help set up your account and walk you through the upload process.

Once we receive this, we’ll send one additional set of Consent forms through a secure DocuSign link.

Planning to use Insurance?  

Insurance is only accepted for Acupuncture services.  While we can issue you a Superbill for reimbursement for other services through some insurance plans, at this time our Chiropractor does not accept any insurance. If you are planning to use INSURANCE for your visit, please also complete the following forms prior to your first appointment to complete additional required forms and verify that we are in network with your plan.

Share Your Time

Give Us Your Feedback

GET
3
=
GIVE
1
MEMBERSHIP
3 wellness sessions
1 service to an underserved community member
$10 tax-deductible donation

giving an additional service
back to a community member

All for only $140 per month!

Member credits are valid for one year after issue and roll over month to month, until expiration. Memberships require 6-month commitments and then become month-to-month agreements. After the initial six-month contract period, you can cancel your membership anytime with a 7-day notice before the next billing cycle.
You are welcome to place a membership on hold for up to 2 months at a time; please note you cannot use credits on your account while it is on hold.
Although the standard membership is only valid for one adult and credits cannot be transferred, children under 12 may use their parent/guardian’s membership credits.

Family Memberships are available!

You can also upgrade an individual membership to a family membership. Add any household member and receive an additional 2 credits a month, with a total of 5 credits to share between the two of you. 

Each new person you add to your account results in 2 more credits to your account and costs an additional $95/month each.

Ready to invest in your health? Talk to a team member or call us at 619-546-4806 to sign up!

SERVICES COVERED:

CHIROPRACTIC

ACUPUNCTURE (RECLINER OR TABLE)

CLINICAL MASSAGE THERAPY (HALF SESSION)

Members may upgrade Clinical Massage Therapy “half sessions” to a Full or Plus session using multiple credits or by paying an upgrade of $25 per 30 min upgrade. Massage Only Membership is also available.