Dr. Harry Maroulakos, D.C.
Welcome to our Chiropractic and Functional
Office at: CORE MEDICAL & WELLNESS
256 Stuyvesant Ave Lyndhurst, NJ 07071
Phone: 888 521-0688
Patient Intake Forms
Appointments
Please call the office to make an appointment in advance. If you are unable to keep your appointment, please call us as far in advance as possible so we may use that time to see another patient in need of care.
If you are a new patient, please arrive to your appointment early in order to complete the registration process.
Please bring the following:
Driver's License or State ID
Referral (If Required by Insurer)
Insurance Information
Copies of Operation Records, Medical Records, X-rays, MRIs, and CT Scans from Prior Doctor Visits
Fees & Payments
We make every effort to decrease the cost of your medical care. Therefore, we request payment arrangements for all office services at the time they are rendered unless prior arrangements have been made. We accept cash, checks, MasterCard, Visa, and Discover for your convenience. If we are a participating provider of your insurance company, we will bill them. However, payment is the patient's responsibility. We will help in any way we can to assist you in handling claims.
Patient Intake Forms
Please print out, fill out the following forms located below and bring to the office for your appointment .
Please click on Patient Intake Page 1 and Patient Intake Page 2.
