New Patient Paperwork
New Patient Paperwork
Please complete the appropriate paperwork before your first visit. This gives Dr. Schallmann a thorough understanding of your health history and current concerns so we can spend more of your visit time on evaluation and discussion rather than administrative tasks. Most patients complete the forms in about 5-10 minutes.
Which Forms Do You Need?
Choose the form set that matches your situation:
Standard New Patient Forms
For patients using regular health insurance or paying out of pocket. Includes health history, current concerns, previous care, and insurance information.
Auto Accident / Personal Injury (PIP) Forms
For patients seeking care following an auto accident using Personal Injury Protection (PIP) coverage. Includes additional information about the accident, insurance claim, and injury details needed for PIP billing.
Please bring: Auto insurance information, claim number, adjuster contact information, and a police report (if available).
Workers' Compensation (L&I) Forms
For patients seeking care for a work-related injury under Washington State Labor and Industries (L&I) coverage. Please complete the Standard New Patient Intake Forms — we'll guide you through the L&I-specific paperwork during your initial visit.
Please bring: Your L&I claim number, employer information, and any communication from your L&I claims manager.
What to Do With Completed Forms
Once your forms are complete, you have three options:
- Bring printed forms to your appointment — Print, complete, and bring to your first visit. Arrive 5 minutes early to hand them over
- Complete digitally and email — If your PDF reader allows form filling, complete on your computer, save, and email to scheduling@backinbalanceredmond.com before your visit
- Complete in office — If you're unable to complete in advance, arrive 15 minutes early and we'll have forms ready for you to complete in the office
Special Situations
New Patients Under 18
A parent or legal guardian must sign the completed new patient paperwork before the initial appointment. All forms must be signed to move forward with care. The parent or legal guardian is welcome to attend the appointment with the minor patient.
Existing Patient File Reactivation or Records Transfer
If you're a returning patient reactivating your file, or a new patient transferring records from another provider, please complete the Records Release Form. This gives us authorization to request your records from your previous provider.
Alternatively, contact us at (425) 437-9974 or scheduling@backinbalanceredmond.com for assistance.
Common Paperwork Questions
How long do the forms take to complete?
Most patients complete the standard forms in about 5-10 minutes. PIP forms take slightly longer (10-15 minutes) due to additional accident-related information required.
Can I complete the forms during my appointment instead of in advance?
Yes. If completing paperwork in advance isn't possible, please arrive 15 minutes early and we'll have forms ready for you to complete in the office.
What if I don't have all my insurance information?
Provide whatever you have. We can verify your specific benefits before your visit or during your initial consultation. If needed, we can also work with you to gather any additional information.
Do I need to bring my prior imaging or medical records?
Yes, if you have them. Bring any prior imaging (MRI, CT, X-rays) as physical films, CDs, or digital reports. Also bring any records from specialists related to your condition. If you don't have copies, the Records Release Form allows us to request them from your previous providers.
What if I have questions while completing the forms?
Contact us at (425) 437-9974 or scheduling@backinbalanceredmond.com. Our phone line is answered 24/7 for questions and scheduling.
Is my information secure?
Yes. All health information you provide is protected under HIPAA (Health Insurance Portability and Accountability Act). See our HIPAA Privacy Notice for details on how we protect your information.
Ready to Get Started?
Your initial consultation is complimentary. Complete your paperwork in advance and we'll be able to spend more of your visit time on evaluation and discussion.
Ready to Feel Your Best?
Take the first step toward better movement and long term wellness with personalised chiropractic care.