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Before your first visit, you will need to complete our new patient forms. Please make sure that you download, print out, and fill out all of the forms in your "category" (whether adult or pediatric). For a "one-click" download, click on the category header. These forms take a long time to fill out, so please give yourself enough time! If they are not filled out before your first visit, it will cut into your appointment time with Dr. Berglund. Each patient is required to have their own set of forms. When you come in for your first visit, give your completed forms to the front desk, and they will take care of them for you. |
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adult patient forms (for patients 15 years and older) Individual forms: Confidential patient information Patient questionnaire Patient goals General pain index HIPPA privacy policies HIPPA receipt of privacy policies e-newsletter opt-in form Office policies |
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pediatric patient forms (for patients 14 years and younger) Individual forms: Pediatric patient information Patient goals General pain index HIPPA privacy policies HIPPA receipt of privacy policies e-newsletter opt-in form Office Policies |
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If you are unable to print out these forms, please call our front desk and we will have them mailed to you. If your appointment date doesn’t allow for the forms to be mailed, please come in for your appointment 40 minutes early, and we will provide you with the appropriate forms to fill out. Do you have additional information (medical records, etc.) that you feel may be helpful for Dr. Berglund while treating you? Please bring it along! Dr. Berglund is an out-of-network provider for all types of insurance. If you would like to schedule an appointment, please call our staff with your insurance information, and we will verify what your out-of-network benefits are. If you do not have insurance, or if you do not want to submit anything to your insurance company, we offer a 50% “same day cash” discount. This means that if you pay for your office visit on the same day of service (cash, check, credit card or debit card), we will take 50% off of your office visit charge. (Services MUST be paid for on the same day to receive the discount!) Supplements, blood draws & lab work, and retail items do not apply. |
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Be sure to visit our resources page for podcasts, health-related articles, recipes, Dr. Berglund’s lecture schedule, and more! |
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| Click here to read success stories from some of our patients!
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