New Patient Process & Forms
Ready to get started?
Complete the following steps to feel better today.
Step 1: Fill out the Request an Appointment form or call 701.365.0999 and one of our staff would be happy to assist you on getting your initial information. This initial step helps us to determine what you seek from our clinic, the complexity of your case, if an initial consultation is needed, and forms to direct you towards.
Step 2: Complete the below New Patient Forms –
If it was determined by the staff or initial consultation that the nature or complexity of your case necessitates any of the below specialty forms, please complete the applicable form(s) in addition to above:
- Brain Region Localization Form
- Neurotransmitter Assessment Form
- Peripheral Nerve Localization Form
- Vestibular Localization Form
- MVA Intake Form
Step 3: Gather any pertinent medical records pertaining to your condition including any labs, imaging (i.e. MRI, CT, etc), or additional records you wish to have reviewed by our doctors
Step 4: Return to our clinic 24 hours before your appointment with –
- Your initial patient forms (Step 2)
- Any additional pertinent past medical records (Step 3).
- If you are unable to provide our clinic the above information 24 hours before your appointment, please arrive 15-20 minutes prior to your appointment with the completed forms to allow the staff time to input your information and the doctor time to review your information as to utilize your scheduled appointment time as efficiently as possible.
- If you cannot complete your paperwork prior to your appointment, please arrive 20-30 minutes earlier to fill out paperwork in addition to the time needed for the staff and doctor to prepare for your appointment. Please keep in mind that handing in completed paperwork late may compromise the essential time intended for the doctor to fully complete your initial appointment for that day.
- If the clinic will be running your appointment through insurance, please provide your insurance with your initial paperwork as well.
If you have to cancel or reschedule your appointment, please call 24 hours in advance so we can open the appointment slot for someone else. If you have any further questions, please feel free to contact us at (701) 365-0999.
Payment & Insurance
NeuroLife is unique in our specialty as a blended cash/insurance clinic.
For patients who plan to utilize health insurance, we believe that Insurance is a contract between the patient and their carrier, so it is important that you take responsibility for understanding your benefits. If you have a question or concern with your reimbursement, you will need to contact your insurance company. We cannot be certain if your insurance covers chiropractic care, although most policies do provide coverage. The amount they contribute to your care varies from one policy to another. Some policies may also have a limit of visits that they will cover. The responsibility for payment for our fees lies directly with the patient. It is NOT the clinic’s responsibility to act as a patient’s agent in negotiating payment from insurance companies or Medicare. However, we will send all charges to your insurance company on your behalf.
What To Expect
What to Expect at Your First Appointment
Depending upon complexity of the case, you can expect the first appointment to last from 60 – 80 minutes. In more complex cases it is many times useful to have a loved one with you to help take in the amount of information that we cover during the first appointment. Pertinent medical records and intake forms are requested 24 hours prior to the visit to allow the doctors sufficient time to study and prepare for your case. This also allows the doctors to best utilize your first appointment time to gather a comprehensive history, conduct an examination and recommend treatment options.
We’ll gather most of the history we’ll need with the intake forms and by reviewing your prior records, but we will still discuss your case with you in person and uncover additional information about how you’re feeling and what we can do for you. We make sure that their is time to hear your whole story.
Once we have a sufficient history about you, we will move on to the examination, which will include a combination of vitals and physical, neurological, and orthopedic related testing that is tailored to your case. This time is spent finding answers to the source of your problem.
At this point one of two things may happen: If this is a complex case with unique components, time will be set aside for the doctor to study your case and do a review of the findings. During this time you will have time to go to lunch and return to the office for a separate appointment to go through the findings, answer questions, and trial an initial treatment. If your case is more straightforward and time permits after reviewing exam findings and impressions, a trial initial treatment can take place directly after your assessment.
Our next steps include an initial treatment plan that is tailored specifically for you will be proposed. In this way we are very different than other clinics where you may have previously sought treatment. Our goal at NeuroLife is to get you better yesterday. In order to do this, we collect the information from the first appointment and combine it with the information from your first few visits, which helps us determine the integrity of your system along with the frequency, intensity, and timing of treatment that will optimize your care. Once this information is obtained, we’ll confidently finalize a plan that can be forecasted to reach your goals. Since every individual is different and our success in treating your problems is the most important goal, we make sure to adapt our plan as we see how you respond during your first few visits.
Good Faith Estimate
Good Faith Estimate
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
- You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
- Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
- Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.
Local Hotel Accommodations
Negotiated rates with area hotels have been negotiated for those traveling distances
Please request the “Patient Rate”.
Contact information: (701) 235-3150
Please request the “Medical Rate for Dakota Health Solutions (NeuroLife)”.
4625 23rd Ave S, Fargo, ND 58104
Contact information: (701) 492-6245