New Patients

Welcome and Thank You for Choosing Pompa Wellness!

If you are new patient, please watch the video below regarding the use of perfumes, lotions, hair products etc, the day of your appointment/visit.

Are you a New Patient?

If so, please download and complete the following questionnaires, prior to your first visit:

1. Neurotoxic Questionnaire - CLICK HERE to download.
2. Symptom Questionnaire - CLICK HERE to download.
3. HIPPA Policy - CLICK HERE to download.
4. Credit Card Authorization - CLICK HERE to download.
5. Appointment Policy - CLICK HERE to download.
6. Nutrition Policies - CLICK HERE to download

Once you have completed the forms you can submit them back to our office by:

Faxing them to: (800) 833-2941
Scanning and emailing them to: info@drpompa.com
Mailing them to: Pompa Wellness 42 Southwind Circle Champion, PA 15622

Please note - Insurance companies do not cover nutrition consultations however most insurances have chiropractic coverage dependent upon the plan.

Are you thinking of becoming a New Patient?

Please contact our office at (800) 833-2941 to speak to a Nutritional Expert. To learn more about the programs we offer in our office, please see "Office Programs".

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