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Location

Location:

9605 Arrow Route Ste. B

Rancho Cucamonga, CA 91730

(909) 257-7044




Rancho Cucamonga Chiropractor | New Patient Forms
New Patient Forms

To serve you better please print and fill out New Patient Forms before your initial visit. If you do not have it completed ahead of time you will need to fill it out in the office. You will see the doctor sooner by having your paper work ready! Thank you!

 

 


 



Click Here for Consent to Treat Form

Click Here for HIPPA (Health Information Privacy Act) Form page 1

Click Here for HIPPA (Health Information Privacy Act) Form page 2

Click Here for Assignment of Insurance Benefits Form

Click Here for Request to Bill Insurance Form


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ProSportsDoctor.com
(909) 257-7044

Success Stories

Maria F | Upland, CA

My daughter has been working with Dr. Frank for at least 3 years now.  She previously had been sick all the time especially with swollen tonsils, ear infections and sinus infections.  Her primary care doctor wanted to take out her tonsils and we were ready to do it when we met Dr. Frank.  After working with Dr. Frank, my daughter does not get tonsil, ear or sinus infections any more.

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Newsflash

Consultation
Once the paperwork has been completed, you will have a consultation with the doctor to discuss your health-related problems, concerns, as well as potential treatment options.