Forms and Fees

We value our patients. We also realize that visiting a provider for the first time can be a bit intimidation. We want to do everything we can to eliminate any unnecessary stress, which is why we include the option of printing and completing your minimal paperwork at home. We value your time and will not keep your waiting once you arrive for your appointment. You may make an appointment online or by calling us.
We are excited to meet you and help you with your needs!

If you have any health and medical or other questions regarding your first visit, please don’t hesitate to call us at (407) 660-1200.

New Patients
New Patient Questionnaire (Case History)

Auto Accident Patients
New Patient Questionnaire (Case History)
Standard Disclosure
PIP, No-Fault Application (Auto Accident Form)

Fee Schedule

New Patient Exam – $50
Minimal, non-radicular symptoms requiring no more than 10-15 minutes to evaluate.

New Patient Exam – $70
Moderate symptoms requiring no more than 30-minutes to evaluate.

Spinal Manipulation – $50
Adjustment to 1-3 regions of the spine, following reassessment.

Physical Therapy Modalities (Fees range from $10-$30 each)
1 unit of EMS, ultrasound, traction, Ice/heat, rehab or other

Location and Hours
M-T: 9-5
F: 9-12

David Bennett, DC
2629 W State Road 434, Longwood, FL 32779 United States
(407) 660-1200