New York Chiropractic Associates offers our patient forms online, so you can complete them in the convenience of your own home or office.
- If you do not already have AdobeReader® installed on your computer, Click Here to download.
- Download the necessary form(s), print it out and fill in the required information.
- Fax us your printed and completed form(s) to 212-861-4769 or bring it with you to your appointment.
Required for New Patients
Required for Former Patients
Required for Oxford, United Health Care, and Aetna plans managed by ACN
**Please fill out the bottom portion of the patient summary form**
Required for BCBS and Cigna plans managed by American Specialty Health Network (ASHN)