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Following are the New Patient Forms all new patients coming into the office must fill out (over the age of 18).

Save time by filling them out beforehand! Feel free to fax the completed forms to our office or just bring them in with you on your first visit. Welcome to the office!

New Patient Intake Form page 1

New Patient Intake Form page 2 

Terms of Acceptance of Care

Office and Financial Policies

HIPAA Privacy Policy page 1

HIPAA Privacy Policy page 2 

Example of codes you might see on your explanation of benefits (EOB) if using insurance**

**Note: Not necessarily the charges we bill you 

Authorization to bill your insurance (need only fill out if you have insurance)

$47 Gift of Health! New Patients Receive Exam, One Series of X-Rays, Drs. Report, and One Adjustment!

THIS ---->https://crownhillchiropractic.com/new-patient-information/new-patient-paperwork.html

Office Hours

DayMorningAfternoon
Monday10:00 - 1:003:00 - 6:00
TuesdayClosed3:00 - 6:00
Wednesday10:00 - 1:003:00 - 6:00
Thursday10:00 - 1:003:00 - 6:00
Friday10:00 - 1:00Closed
SaturdayClosed
SundayClosed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
10:00 - 1:00 Closed 10:00 - 1:00 10:00 - 1:00 10:00 - 1:00 Closed Closed
3:00 - 6:00 3:00 - 6:00 3:00 - 6:00 3:00 - 6:00 Closed

Testimonial

I have found Dr. Kevin Waugh and his staff to be professional, sensitive, understanding, friendly, and encouraging. From personal experience, I have come to believe in chiropractic medicine, along with naturopathic and traditional medicine, as a total health care practice for myself and my family.

Dana H.
Seattle, WA

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