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                                   Gindele Family Chiropractic, Fort Myers - Neck Pain, Back Pain, Auto Accidents, Wellness

                                  WELCOME to our office. We are happy you made the choice to make our office your Wellness Headquarters. We look forward to serving you.

                                  Find out more about Chiropractic by clicking HERE.

                                  New Patient Paperwork
                                  If you would like to save yourself time at your first appointment, please print and fill out the paperwork and bring it with you to your first appointment.  Please be sure to fill out the New Patient Intake as completely as possible. If you have any questions in regards to the paperwork, please let us know at your appointment.  Thank you.

                                  NOTE!! 
                                  All paperwork is password protected so please choose
                                  "Read Only" to print.

                                  General Paperwork -

                                  new_patient_intake_2011.doc
                                  File Size: 87 kb
                                  File Type: doc
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                                  privacy_practice.doc
                                  File Size: 66 kb
                                  File Type: doc
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                                  gindele_family_chiropracticpolicy.doc
                                  File Size: 38 kb
                                  File Type: doc
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                                  open_adjusting_agreement.doc
                                  File Size: 65 kb
                                  File Type: doc
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                                  informed_consent.doc
                                  File Size: 26 kb
                                  File Type: doc
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                                  Insurance Forms

                                  insurance_1500_signature.jpg
                                  File Size: 1648 kb
                                  File Type: jpg
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                                  Medicare Specific Forms

                                  medicare_abn.doc
                                  File Size: 58 kb
                                  File Type: doc
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                                  medicare_policy.doc
                                  File Size: 63 kb
                                  File Type: doc
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