CHECK MY INSURANCE -

ABOUT INSURANCE
We can work with your insurance company as long as you have out of network benefits and your deductible is met or is below $1000. If we are not able to work with your insurance company we will offer you our cash discounted fees. All cash practice members join a discount club for chiropractic called CHIROHEALTH USA, which is $49 for the year to join, for the whole family. We do not participate with any insurance companies, including medicare.

Please submit your insurance information:

* Indicates required field

Patient Name *

First

Last

Patient DOB *

Do you have out of network benefits with your insurance? *

Yes No I'm not sure

Is your deductible for out of network providers met for the year? *

Yes No I'm not sure

Insured's Name *

Insured's DOB *

Phone Number of Patient *

Insurance Company *

Policy Number *

Group Number *

Insurance Phone Number *

Insurance Zip Code (usually on back of card) *

Email of Patient *

Submit

Please submit your insurance information:

​LIGHTSOURCE CHIROPRACTIC OF CLINTON 6 East Main Street, Suite 6​Clinton NJ 08809 ​908.238.1081LIGHTSOURCE CHIROPRACTIC OF PRINCETON360 Nassau Street, next to Whole Earth CenterPrinceton, NJ 08540 609-924-6200

LIGHTSOURCE CHIROPRACTIC OF CLINTON
6 East Main Street, Suite 6
Clinton NJ 08809 908.238.1081

LIGHTSOURCE CHIROPRACTIC OF PRINCETON
360 Nassau Street, next to Whole Earth Center
Princeton, NJ 08540 609-924-6200