Sitzmann Chiropractic
224 Feaster Rd. Suite C Greenville, SC  29615
(864) 458-8888 
                                                                                                                                                                             

Save some time in the office! Below you will find some of the most common forms that you can download and complete prior to arriving in the office. Please note: You may be required to present your insurance card upon arrival so please plan on bringing your card with you.

New! 2011 Patient Update Form - Patient are asked to complete this form prior to their first visit in 2010. This allows us to have the most accurate information on hand. 

Patient Update Form  - Has it been at least 4 months since your last visit to our office? If so, this form is for you! 

New Patient Intake Form  - If you are new to Sitzmann Chiropractic, we ask that you complete all of the paperwork in this section, starting with our intake form

New Patient Health Evaluation Form 

Informed Consent 

Terms of Acceptance 

HIPPA Form  - Please note: This form is mandatory. If you are faxing your information back to us prior to your initial visit we must have this form faxed along with all information.

Outline for Procedure of Care 

Medicare ABN Notice - This form is for Medicare patients only.

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Additional Forms: 

Release of Medical Records  - Use this form if we are going to receive a copy of your medical records from your current healthcare provider

Release of X-Rays  - Use this form if you need your X-Rays released to you

Motor Vehical Accident Survey  - In the unfortunate event that you have been in a car accident, there will be additional paperwork needed. Please complete all information as thoroughly and accurately as possible. DO NOT LEAVE ANY INFORMATION BLANK. 

Automobile Accident Questionaire  - You will need to provide a copy of the accident report upon arrival. If you have the original we will make a copy and you will keep the original.


When faxing forms please use a cover letter and fax to: 864-458-8848 ATTN: Reception

When emailing forms please provide a contact number in case we need to reach you. Emails should be sent to: sitzchiro@bellsouth.net ATTN: Reception