At this time, we are accepting new patients for Dr. Sam or Dr. Jennie. We look forward to working with you!
Phone: 320-269-3211 or 866-442-4673
Location: 804 North 16th Street, Montevideo, MN 56265
Please call or stop by our office to reserve a time for a new patient appointment. We will do our best to accommodate your scheduling needs. Please remember, you were referred to our office by someone who likes our approach to their healthcare and our doctors stay busy helping those established patients for the majority of the day! Same-day new patient appointments may be available if we have a cancellation, but we can’t guarantee that. A new patient appointment is longer than a follow-up visit as our doctors spend extra time learning about your health history and thoroughly examining you. Please plan for 45-60 minutes at our office (for an adult) for check-in, paperwork, examination, any recommended radiology, & your first chiropractic adjustment.
Forms
Print out the appropriate new patient intake form below, fill it out to the best of your knowledge, and bring it with you to your first appointment.
- New Chiropractic Patient History Form – Primary Complaint: Neck, Headache or Upper Extremity
- New Chiropractic Patient History Form – Primary Complaint: Back, Lower Extremity or Other
- Child New Chiropractic Patient History Form (under age 10)
- Automobile Accident New Chiropractic Patient History Form
- Worker’s Compensation New Chiropractic Patient History Form
Other Forms
- Minnesota (MSHSL) 7-12th grade Sports Physical Form– Parent/athlete needs to complete all of page 2, and just the personal information (top) & emergency information (bottom) of page 1.
- DOT Physical Examination Form- Driver needs to complete all of page 1 and all of page 2 until the driver signature.
Payment
Our facility offers many options for payment of your care here. We can provide you additional information about our self-pay options when you make your first appointment. For many of our patients, this is the most cost-effective route. The doctors at our facility are also in-network providers with many health insurance companies including (but not limited to) the following list of companies. Our team can verify your chiropractic benefits and help you understand your coverage so you can make an informed decision about your payment options.
- Blue Cross Blue Shield
- Medicare
- Veteran’s Administration (VA) Community Care Program
- Medical Assistance
- Blue Plus
- Medica
- Health Partners
- Cigna
- UCare
- Preferred One
- PrimeWest
HIPAA Privacy
Cornerstone Chiropractic Health Partners Notice of Privacy Practices