Applied Kinesiology and Traditional Chiropractic Wellness Care
Dr. Iohann Gonzalez, DC
6300 Stonewood Drive
  Suite 110    Plano, Texas  75024    (972) 769-8750

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Chiropractic care for the
entire family

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Payment Options
HMO/PPO
Blue Cross/Blue Shield
Automobile Insurance
Attorney Liens
Worker's Compensation
Visa/MasterCard

Patient Financing Available


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 





 

 

Patient History Forms


Before your first visit our office, you might be asked to fill out and print one of the following patient history forms, and bring it with you.  

To print these forms please do not select "File" from your browser, then "Print" to print these forms.  Instead, after you click on one of the links below, and the form is displayed, please click on the printer icon next to the "Save a Copy" disk icon in the upper left portion of the screen, just above the form.

CHIROPRACTIC PATIENT FORMS:

    1. New Patient Intake Form

    2. Financial Agreement Form


ALLERGY PATIENT FORMS:

    1.  New Patient Intake Form      

    2.  Financial Agreement Form

    3.  New Patient Information Form

    4.  Waiver and Release Form


   

DISCLAIMER: No individuals, including those under our active care, should use the information, resources or tools contained within to self-diagnose or self-treat any health-related condition. Diagnosis and treatment of all health conditions should only be performed by your doctor of chiropractic or other licensed health care professional.

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(209) 473-8423    (800) 506-5866   Questions about this site:  Email JFAlward@aol.com.