Dr. David J Schimp DC LLC


262.673.2341



APPOINTMENTS






To schedule an appointment please call 262.673.2341 or use the Appointment Request Form or schedule through the On-Line Portal below.​


APPOINTMENT REQUEST FORM - CLICK TO COMPLETE THIS FORM


Kindly provide 24 hour notice if you need to cancel or reschedule an appointment.


Additional appointments may be available - if you do not see an appointment on the scheduler below call the clinic for earliest available appointment or wait list.




CHIROPRACTIC APPOINTMENT



If you are a new chiropractic patient please complete the New Patient Health History Intake Form (below) and fax or bring to your appointment.





FUNCTIONAL MEDICINE APPOINTMENT




Accepting new patients for functional medicine appointments.


Please complete the requested forms and provide us with the additional items on the checklist below. Please fax or mail the requested information to us 1 week in advance of your scheduled appointment.


Checklist of Requested Items:


  1. Functional Medicine Health History Intake Form
  2. Provide your most recent blood work (past 2 years) and any other lab results relevant to your diagnosis
  3. Cancer patients, please provide the following additional information
    1. Surgical reports
    2. Pathology reports
    3. Any tumor markers or receptor reports where applicable
    4. Most recent x-ray, CT scan, bone scan, MRI and PET scan reports (reports only, not the actual images
  4. Complete the CANCER VISIT - HISTORY INTAKE FORM (and the Functional Medicine Visit forms below)




INTAKE FORM DOWNLOADS



If you are a NEW PATIENT, click the appropriate form links below to download. Please complete and return by mail or fax 262.673.2131 in advance of your appointment.


INFORMED CONSENT FOR CHIROPRACTIC EVALUATION AND TREATMENT


CHIROPRACTIC VISIT - HEALTH HISTORY INTAKE FORM


FEMALE FUNCTIONAL MEDICINE VISIT - COMPREHENSIVE HEALTH HISTORY INTAKE FORMS


MALE FUNCTIONAL MEDICINE VISIT - COMPREHENSIVE HEALTH HISTORY INTAKE FORMS


PATIENT BILL OF RIGHTS AND PRIVACY PRACTICES







payment policy



Payment by cash, major credit card or check is expected at the time services are provided. We will submit a claim to your insurance company for you. If the service is covered by your insurance company you will receive a reimbursement check directly from your insurer.


Services and lab testing are comprehensive and of the highest quality. Costs are priced well below industry standards because we believe that quality health care should be accessible.



Map
Privacy Policy


Monday, Wednesday 8:00am - 5:00pm

Tuesday, Thursday 8:00am - 12:00pm

Friday 8:00am - 4:00pm


262.673.2341

Fax 262.673.2131

​



Dr. David J Schimp DC LLC



937 E. Sumner Street, Hartford WI 53027