David Bennett, DC
David Bennett, DC
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  • Auto Accident?
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    • Home
    • About Us
    • New Patients
    • Services
    • Auto Accident?
    • Contact Us
  • Home
  • About Us
  • New Patients
  • Services
  • Auto Accident?
  • Contact Us

Health and Therapy Forms and Fees

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 stressors, 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!  Remember, have been located in Altamonte Springs for over 35 years.


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.

Forms


New Patients

  •     New Patient Questionnaire (Case History)
  •     Consent To Treat Form
  •     HIPAA Disclosure
  •     Office Policy


Auto Accident Patients

  •     New Patient Questionnaire (Case History)
  •     Consent To Treat Form
  •     HIPAA Disclosure
  •     Standard Disclosure
  •     PIP, No-Fault Application (Auto Accident Form)


Documents

  •     Dr. Bennett’s Professional License
  •     County Business License
  •     License Look-Up


Fee Schedule

  •     New Patient Exam – $50

                    Minimal 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

  •     Cryoderm Topical Analgesic – $15

                    Topical pain reliever in gel, roll-on or spray bottle.

  •    Standard Process nutritional products

                    High Quality, Whole food-based nutritional Supplements.


Find out more
Schedule an Appointment

Professional License

Case History (pdf)Download
Auto Accident Form (pdf)Download
Consent to Treat (pdf)Download
Office Policy (pdf)Download
Professional License (pdf)Download

Location and Hours

David Bennett, DC

901 Douglas Avenue Ste 109, Altamonte Springs, Florida 32714, United States

(407) 660-1200

Open today

09:00 am – 03:00 pm

  • About Us

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