Insurance & Forms (OLD)


Langford and Karls Chiropractic is a provider of all major insurance companies, including BlueCross BlueShield, Health Partners, Medica, United Healthcare, Medicare, Medicaid, and many more. We recommend that you call your insurance company to verify your benefits before making your first appointment.

Insurance companies have many plans with differing benefits and it is ultimately the patient’s responsibility to verify their coverage and understand the benefits you have. We are always available to answer any questions you may have, and we work diligently to make the insurance process as seamless as possible.

New Patient Forms

Adult New Patient Packet 

Pediatric (ages 0-5) New Patient Packet

Child (ages 6-9) New Patient Packet 

Minor (ages 10-17) New Patient Packet 

Adult New Patient Packet (Car Accident/Personal Injury)

Adult New Patient Packet (Workman’s Compensation)

If you prefer to not go through insurance, we conveniently offer a Same Day of Service Payment Plan. If you would like to utilize this plan, please also fill out the following form in addition to one of the above packets. Please note that for your first visit the History and Examination is not included in the plan and will be an extra charge as shown on the form:

Same Day Cash Discount Form