IMPORTANT ANNOUNCEMENT:

When you Arrive for your Appointment

  • • Call 631-736-4414 to let us know you have arrived, and stay in your car. We will then call you to let you know when to come in. Your temperature will be taken , and we will ask you a series of questions about Covid-19. We will need to know if you are waiting on a test, are in a quarantine period, or just returned from a state on the NY restricted travel list.
  • • You must wear a mask at all times while in our office, and you must sanitize your hands upon entering the office

Our Covid-19 Safety Measures to Keep You Safe

  • • All patients and staff must wear facial masks and use hand sanitizer frequently. Hand sanitizer is available throughout the office
  • • Social distancing must be maintained.
  • We disinfect and wipe down all treatment surfaces before and after all patient encounters, and sanitize our hands before and after every patient encounter
  • • We disinfect and wipe down all office surfaces including door handles, pens, light switches, and chairs
  • • In between shifts we disinfect treatment areas with Ultraviolet Lamps for extra precaution

Updated 08/03/2020

636 Middle Country Rd, Selden, NY 11784

Call Us: (631) 736-4414

Coram-Selden Chiropractic

Dr. David BenEliyahu - Dr. Ronald Spinelle
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Coram-Selden Chiropractic
2021-01-17
https://www.drbenchiro.com
Coram-Selden Chiropractic

New Patient Forms

Please print and complete parts 1 and 2 of the initial intake forms.

Select insurance (part 1):

Hip, Vytra, GHI

BC/BC, Cigna, Magnacare, Health Republic, No Insurance, 1199

Medicare

MPN, UHC, Aetna, Oxford

Workers Compensation Intake Forms

No Fault Intake Forms

Intake part 2 (to be completed by all patients):

Initial Packet Part 2

Appointment Form

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  • 636 Middle Country Rd
    Selden, NY  11784
  • (631) 736-4414
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