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Chiropractor in parma

Chiropractic Health Center of Parma Michael F. Urbanc D.C.

To Schedule An Appointment

Call: 216-898-1445

Text: 216-868-7301

Insurance / Cash Intake Forms

Patient Intake Form

Medical History Form

Consent to Care

HIPPA Privacy Notice

Auto Injury Intake Forms

Patient Intake Form

Medical History Form

PI Accident Description

PI Insurance Info

Release of Records

Worker's Comp Injury Intake Forms

Patient Intake Form

Medical History Form

Description of Accident

FROI-1 (New Claim)

Consent to Care

HIPPA Privacy Notice

HIPPA Privacy Notice

Release of Records

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