Patient Forms

Click on a link below to download the form.

  1. Chiropractic Case History & Patient Information
  2. Electronic Heath Records Intake Form
  3. Financial Policy
  4. Insurance Assignment Policy Statement
  5. Patient Health Information Consent Form
  6. Patients Or Authorized Persons Signature

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Other forms that may need your signature are available at the office.

Insurance Info

Group or Individual Insurance

We attempt to take out as much of the "insurance hassle" as possible for you. We'll happily telephone your insurance company to verify your coverage benefits. Please remember, however, that the benefits quoted to us by your insurance company are not a guarantee of payment. We will file your claim and await payment for 90 days. If your company pays the benefits they quote to us, the only services you will be responsible for are any non-covered services, deductibles or co-pays. If you have any questions at all regarding you financial responsibilities at our office, please do not hesitate to ask. Our insurance clerk has years of experience and will be happy to assist you.

Patients Without Insurance

An increasing number of patients do not have insurance, or have plans with limited coverage, such as catastrophic policies. We realize that no one wants to build up a large bill. Therefore, we have several plans so those patients may receive complete care without undue financial difficulty. Of course we are always happy to accept cash, your personal check, or most major credit cards.

Clinic Info


We are proud to provide a warm and friendly facility for the highest quality chiropractic care available. It is one of our top priorities to protect the well-being of our valued patients. We are confident that you will feel right at home in our office as we welcome all patients as if they were family.


We will do our best to accommodate you and your family for the appointment time that you need. Appointments made in advance are always encouraged so we may help eliminate any long wait. We facilitate emergencies and make time to welcome new patients.

Mattar Chiropractic Clinic

39949 Garfield Rd. Ste. B
Clinton Twp, MI. 48038
Phone: 586-286-1112
Fax: 586-412-3673