Washington Park Chiropractic offers our patient forms to download and print so they can be completed before you arrive to our office. This will save you time so please complete them prior to your appointment. New Patients should arrive 15-20 minutes early to allow for finding our parking lot. When heading south on Buchtel Blvd, make a right on South Clarkson Street and immediately on your right you will see a parking lot for the Louisiana Staton Lofts. We have a row of parking spaces along the south fence and there is plenty of parking on Clarkson Street, Washington Street and Louisiana Boulevard. If you have any questions on parking or which forms you need, please call us at 303-744-7100.
Download the necessary form(s), print it out and fill in the required information.
Email us your completed form(s) to or bring it with you to your appointment.
Please Note: Although we are a family practice and love seeing children in our office, due to liability reasons, we cannot accommodate childcare during any massage or acupuncture appointments.
Adult Chiropractic Patients (Age 18 and over)
Pediatric Chiropractic Patients
Age: Birth - 2 Months
Age: 2 Months - 2 Years
Age: 3 Years - 11 Years
Age: 12 Years - 17 Years
Telemedicine Informed Consent
Acupuncture Only Patients
Massage Only Patients
*Please note that we cannot accommodate childcare for any massage appointment.
Nutrition Only Patients
Car Accident Adult Chiropractic Patients
(Age 18 and Over)
Car Accident Pediatric Chiropractic Patients
(Age 17 and Under)
Payment and No Show/Cancellation Policy
How Insurance Works In Our Office:
Washington Park Chiropractic is an out-of-network provider with all insurance companies. With out-of-network insurance, there is usually a separate deductible that must be met and collected before the insurance company will pay for services. After that, your insurance company will cover a percentage of your care and you will be responsible for the rest. Most insurance companies allow us to accept assignment, which means that after your deductible is met we only have to collect the percentage you are responsible for. We do not accept Anthem / Blue Cross Blue Shield or Aetna insurance. We are not part of the chiropractic network that Kaiser supports. Since we are an out-of-network provider, we do not accept HMO plans. We do not accept Medicaid. To learn more about why we are a out-of-network provider, please click here.