New Patient Paperwork

Belle Fourche Family Chiropractic offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • All forms are PDF files. You will need AdobeReader® to view them.
  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Fax us your printed and completed form(s) or bring them with you to your appointment.

Accepted Insurances

  • Medica Plans
  • Medica
  • Signature Wellness Plan
  • Health Allies
  • Access One Consumer Health
  • Medical Resource, LLC
  • United Health Care
  • Premera Healthcare
  • Premera Blue Cross
  • MedRisk
  • Cypress Care
  • Universal SmartComp
  • TechHealth
  • Rockport
  • Align Networks, Inc.
  • BCBS
  • Dakota CAre
  • Avera
  • Aetna
  • Coventry
  • First Choice of The Midwest
  • Midlands Choice
  • Cigan Payor
  • Medicare
  • AARP
  • Family Life Insurace
  • Mutual of Omaha

OFFICE HOURS


Monday
10:00am - 1:00pm
3:00pm - 5:30pm


Tuesday
3:00pm - 5:30pm


Wednesday
10:00am - 1:00pm
3:00pm - 5:30pm


Thursday
3:00pm - 5:30pm


Friday
10:00am - 1:00pm


Saturday
Closed

Belle Fourche Family Chiropractic
1407 5th Avenue #200
Belle Fourche, SD 57717
(605) 723-3434

ABOUT US

Find out more about our
comprehensive approach.

CONTACT

1407 5th Avenue #200
Belle Fourche, SD 57717
(605) 723-3434

OFFICE HOURS

We look forward to helping you
schedule your next appointment.