Patient Paperwork

Korman Relief & Wellness Center offers the convenience of completing necessary paperwork in the comfort of your own home or office.  You will see a list of various categories of services we offer below.  Please, print your forms,  answer all questions, and sign each form requesting a signature. (If you feel a question does not apply to you, or does not have an answer, please mark the question as "N/A," or "Not Applicable".)

 We cannot start your appointment until your paperwork is entirely complete.  Any delays in the waiting room due to incomplete paperwork takes away from your time with the doctor and could result in the rescheduling of your appointment.

Should you have questions about your paperwork, please call our office, and we will be happy to help you! Based on your convenience and schedule, your paperwork can be delivered by any one of the means below:

  • Mail the completed, signed forms to our office so that they arrive prior to your appointment date.
  • Bring the completed, signed forms to our office front desk when you’re “out and about”!
  • Bring the completed paperwork when you arrive, at least 10 minutes before your appointment time

Attention - Nutrition Patients:  Dr. Korman MUST have your paperwork AT LEAST ONE DAY PRIOR  to your appointment in order for her to review your history and be fully prepared for her visit with you.  If your paperwork is not received at least one day prior, your appointment WILL be rescheduled.

 

Auto Accidents/Personal Injury

 

Chiropractic - New Patient


Laser Therapy - New Patient


Massage Therapy - New Patient


Neuropathy - New Patient


Nutrition - New Patient

Dr. Korman needs your completed Nutrition paperwork at least one working day prior to your appointment.  There is much for her to review before she sits with you, and she wants to make the most of your appointment time.  You MUST get your paperwork to us at least a full day ahead, or your appointment will be rescheduled.

 

Nutrition - Established Patient


Pediatric New Patient


Returning Established Patient


Why Must I Complete All These Forms?


The purpose of these forms and questionnaires is to educate the Doctor about your past health history, as well as the current state of your health.  This enables her to design a treatment plan which focuses on your specific health situation. In addition, we need it on file that you give consent to be treated by our office, and that you understand, and agree, that you, as the patient, are responsible for payment. You will also be asked to sign "HIPAA" forms when you arrive for your first appointment, which are required, and explain your privacy and patient rights. 

In order to provide services to you, we absolutely must have these signed, completed, forms in place.  

Should you experience frustration with the online paperwork, please call our office and request the paperwork be mailed to you, or stop by and pick up the paperwork at the front desk, prior to your appointment date.  We understand not everyone wants, or has the ability, to print forms from their computers.

Thanks so much for your kind cooperation.  We look forward to helping you along your road to wellness!