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  Burki Chiropractic Center of Gig Harbor Washington
 


At Burki Chiropractic Center we want to give you the best chiropractic care possible. To expedite scheduling, please fill out this form so we may verify your insurance coverage. Once we verify your insurance we will contact you to set up an appointment time or call you to gather further information.

Most major medical benefits cover chiropractic care, however, there are often caps or limits to the coverage. Please check with your insurance company prior to your first visit for accurate coverage information. A list of acceptable insurance companies is provided below.
insurance verification
It is the policy of Burki Chiropractic Center that deductibles, co-payments and any related service fees are due at the time of service. No fault injuries with full insurance assignment and worker's compensation plans may not incur out of pocket expenses.

 
 
Name
Phone
E-mail
Policy holder
Policy #
Insurance company
Insurance phone #
Comments
complaints

back/neck/arm/leg pain
back/neck/arm/leg numbness

work injury
accident
  Please verify my insurance coverage
By submitting this information, I authorize Burki Chiropractic Center to contact my insurance company to verify my enrollment and coverage information. I understand that Burki Chiropractic Center will not give/sell or use my information to/for any purpose or outside sources and will use this information solely for verification purposes as I have indicated above.

Insurance Links provided for your convenience:

Aetna
Blue Cross & Blue Shield
Kaiser
Regence

L & I
Group Health
Medicare

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Copyright 2001, Burki Chiropractic Center
4423 Point Fosdick Drive Suite 310 Gig Harbor, Washington 98335 | Phone: 253.851.5900 | FAX: 253.851.5910

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