Dr. Cayer Chiropractic New Patient Paperwork and Forms
New Patient Resources

Paperwork & Patient Forms

Save time at your first visit — download and complete your new patient intake forms before you arrive at our Newtown, CT office. Questions? Call us anytime.

We are in network with Anthem and work with most major insurance plans. Call 203-426-4700 to verify your coverage.
Before Your First Visit

How to Prepare

1

Complete Forms Below

Fill out the three required forms online — right here on this page.

2

Submit Each Form

Submit each form individually. You'll see a confirmation when it's received.

3

Arrive 10 Min Early

Plan to arrive 10 minutes early on your first visit to allow check-in time.

4

Bring Insurance Card

Bring your insurance card and a valid photo ID to your first appointment.

Complete Online

Required Patient Forms

Fill out all three forms below before your first appointment. Each form submits separately — you'll see a confirmation when each one is received.

New Patient Intake Form

Personal info, emergency contact, insurance & reason for visit

Personal Information

Emergency Contact

Insurance Information

Reason for Visit

Additional Paperwork

Other Forms

Complete these only if they apply to your situation.

Required

Financial Policy & Assignment of Benefits

Outlines payment expectations, insurance billing procedures, and assignment of benefits to our office.

Download PDF
If Applicable

Auto Accident Injury Form

For patients injured in a motor vehicle accident. Documents incident details and injuries.

Download PDF
If Applicable

Workers' Compensation Form

For patients seeking treatment for a work-related injury. Includes employer and claim information.

Download PDF
Need Help?

Questions About Your Forms?

If you have trouble with any form or have questions about your upcoming appointment, reach out and we'll get back to you quickly.

Send Us a Message

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Ready to schedule your first visit?

Complete your paperwork above and call our Newtown, CT office to book your appointment today.