Southeast Chiropractic Patient Center

Forms, Payments, and More

Welcome to the Southeast Chiropractic: The Motion Centers new patient center!

We understand that arriving at a doctor’s office for the first time can be nerve racking. If you’ve never experienced chiropractic care before, you may not know what to expect when you come to our Belmont chiropractic office for the first time. Filling out paperwork, learning new faces and names, and getting to know your way around the office can be an overwhelming experience.
That’s why at Southeast Chiropractic: The Motion Centers our aim is to remove any unnecessary stress or tension and make you feel comfortable during your visit with our chiropractor.
In this area of the website, you will be able to take care of items necessary for your visit prior to arriving. If you have any questions at any time, please don’t hesitate to contact our Belmont chiropractic office at

Download Online Forms

Southeast Chiropractic: The Motion Center offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, click here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Forms

Major Medical Intake Forms (also use if no medical insurance)
Download & Print Form

Personal Injury Intake Forms (Auto Accident/Worker’s Comp)
Download & Print Form

Información Personal y Confidencial Del Paciente (en español)
Download & Print Form

Personal Injury Intake Forms (en español)
Download & Print Form

Download the Free Adobe Reader®

Payment Option

Southeast Chiropractic: The Motion Centers believes in the value of wellness care for you and your family and have maintained a pricing structure that allows care for all budgets. Our office participates in most insurance programs. We also accept auto accident and workers compensation cases. For patients who have little or no chiropractic insurance coverage, flexible payment programs can be arranged. To learn more about our payment options for chiropractic and wellness care, you can call our office directly.

Insurance

Most insurance plans are accepted at our office. We accept auto accident, workers compensation, personal injury and most health insurance plans, including Medicare. Since there are so many plans and coverage varies widely, please call us to find out if your plan covers care in our office. Our staff will verify and explain your benefits before treatment, at no charge.

No Insurance

For patients who have little or no chiropractic insurance coverage, flexible payment programs can be arranged. If you have no insurance or do not have chiropractic benefits there is still a way for you to receive the care you need. Many patients pay directly for care, as they discover chiropractic to be extremely cost-effective and affordable.

Health on a Budget

At Southeast Chiropractic: The Motion Centers, we’re convinced that a small amount of your time and money to care for your most important asset–your health–will be far less time consuming and expensive than trying to recover it. If you feel you do not have enough time or money to take care of yourself, please contact us–we can help! The last thing we want is for you to come to our wellness center in crisis. So please, we would like to encourage you to take your health very seriously. As the old saying goes, if you don’t have your health, you don’t have anything. Unfortunately, too many people don’t discover how true that statement is until it is too late.

Our Patients Say

We love hearing from our patients about how chiropractic care has helped them improve their health and well-being. Here are just a few testimonials:

Joe

I have been a patient of Southeast Chiropractic for many years and I can honestly say that they have changed my life. I used to suffer from chronic back pain, but after just a few adjustments from Dr. Snyder, I started to feel significant relief. Now, with regular maintenance care, I am able to live a pain-free and active life. I highly recommend Southeast Chiropractic to anyone looking for a chiropractor who can help them achieve their health and wellness goals.

Joe Dostie
Kim

I highly recommend Southeast Chiropractor to anyone who is looking for a chiropractor. Dr. Snyder is the best chiropractor I have ever seen. He is knowledgeable, skilled, and compassionate. He is truly dedicated to helping his patients.

Kimberley Odom

Dr. Snyder is the best chiropractor that I have seen over the years. Dr. Magic Hands has the best staff and a very comfortable and relaxing atmosphere.

Ric Franklin

I love Dr. Snyder and all the staff. They help me get back on my feet.

Becky Martin Lawing

I have been a patient of Dr. Snyder‘s for about four years now. Not only do I receive enormous comfort and relief with clear explanations of what is needed and how I am being helped, but I thoroughly enjoy each appointment. The office is a warm, friendly environment and I receive genuine care, love and concern from everyone who works there! I feel like I am treating myself just to be there without even having the chiropractic work done! I can’t recommend Dr. Snyder enough, and I would personally like to invite everyone to experience the cheerful, inviting atmosphere and hospitality extended by the staff! Thank you Dr. Snyder for how much you have helped me, and thank you Ashley and Caressa, for always making my visit the uplifting experience I need in a world filled with turmoil. You are the best!

Lori Spargo

I received permanent injury to spine & SI Joint in an accident. After 6 epidural steroid shots and 7 trigger shots I still had pain. Dr. Snyder is the only one who addressed my pain with success. He has helped me tremendously with my gait, low back, SI joint pain and I would highly recommend him!! His staff, Carresa, Kayla and Ashle, are great and All ‘very Professional!’

Faith Nagel in Gastonia, NC
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Make An Appointment

At Southeast Chiropractic, serving Belmont, NC, and the surrounding region, Dr. Snyder is providing the area with a natural approach to healing. We can help with a variety of conditions and use various methods, all tailored to your particular condition. Call us today for more information or to schedule an appointment.