Please download and print the appropriate forms prior to your appointment.
After opening and printing a necessary form simply hit the back arrow on the URL toolbar to return to this webpage.
Auto Injury Check-in Form: Double click or Right Click PDF Below. Then Print and complete.
Auto Injury Information Form: Double click or Right Click PDF Below. Then Print and complete.
Auto Injury Payment Form: Double click or Right Click PDF. Then Print and complete.
Work Injury Check-in Form: Double click or Right Click PDF. Then Print and complete.
Work Injury Information Form: Double click or Right Click PDF. Then Print and complete.
Private Pay Check-in Form: Double click or Right Click PDF. Then Print and complete.
Private Pay Information Form: Double click or Right Click PDF Below. Then Print and complete.
If you have any questions or need any assistance at all feel free to give Belanger Body Care a call at 425-670-8851. You can either bring the necessary forms in with you for your appointment or fax them to Belanger Body Care at 425-673-8630.
