We understand your time is valuable.
To help streamline your first visit, we have listed the paperwork needed below as a new patient. Simply click the download button below, print out the forms, and bring the completed forms to your first visit. Thank you for choosing Gose Chiropractic and we look forward to addressing your health needs.
Dr. Gose is a preferred provider for the following insurance plans.
Anthem
Blue Cross Blue Shield (BCBS)
Medben
Medical Mutual of Ohio
Medicare
Medicare Advantage (Anthem/MMOH)
Ohio Healthy
Ohio Health Choice/Plus
Ohio PPO Connect
Peak Health (WVU Medicine/Camden Clark Medical Center) - Coming Soon
Trustmark - The Ohio State University Systems
United Mine Workers of America (UMWA)
UMR - Athens County Schools Consortium/Hopewell Health
Veterans Affairs Community Care Provider
*We do not accept any Ohio Medicaid plans such as: Buckeye Health, CareSource,
Molina, Humana Healthy , Paramount Advantage, Anthem Medicaid. Also, we do not participate in any marketplace health plans.
*We are not providers for UHC Community Plan/UHC Medicare Advantage Plan or Cigna/Aetna Medicare Advantage Plans.
*We are not providers for United Health Care, Cigna or Aetna.
Please call if you are unsure if we are in your current insurance plan.