Dr. Amy Forth | The Pain Relief Centre At The Exchange

Achieve Your Greatest Potential
Do You Need A Chiropractor?

Accidents and injuries can tear loose the connective tissue that holds the spine in place. When the spine breaks down in the torn area it becomes locked into a stressed position. Some indicators of spinal stress are

Neck and Shoulder Pain
Arm/Hand Pain
Hip Pain
Pain down the Leg
Carpal Tunnel Syndrome

Headaches
Back Pain
Sciatica
Tendonitis
Foot and Heel Pain

Do you suffer from any of those symptoms?
Let me help you reach your greatest health potential!

Click here to download the New Patient Information Form

I am a provider in the following insurance networks:

Aetna
Blue Cross/Blue Shield
United Healthcare
Lifewell Health Plans
Golden Rule
GE Wellness Plan
Health Allies

PHCS
Great-West Healthcare
Medicare
Reserve National
Medical Resource, LLC
Evercare - GA
Cigna

Many smaller carriers are not listed here - I would be happy to verify your coverage for you.

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To Contact Us:
Email Dr. Forth
Phone: (678) 449-5759
1755 The Exchange
Ste 150
Atlanta, GA 30339

SUMMARY OF NOTICE OF PRIVACY PRACTICES
We care about our patients' privacy and strive to protect the confidentiality of your medical information at this practice. New federal legislation requires that we issue this official notice of our privacy practices. You have the right to the confidentiality of your medical information, and this practice is required by law to maintain the privacy of that information.

How We May Use and Disclose Medical Information About You

For Treatment. We may use medical information about you to provide you with medical treatment or services.

For Payment. We may use and disclose medical information about you so that the treatment and services you receive from us may be billed and payment collected from you, an insurance company or a third party.

For Health Care Operations. We may use and disclose medical information about you for health care operations to assure that you receive quality care. Example: We may use medical information to review our treatment and services and evaluate the performance of our staff in caring for you.

Uses or Disclosures That Can be Made Without Your Consent or Authorization
In the following circumstances, we may disclose your health information without your written authorization:
    To family members or close friends who are involved in your health care;
    For purposes of Public Health safety;
    To Government agencies for purposes of their audits, investigations and oversight activities;
    To Government authorities to prevent child abuse or domestic violence;
    To the FDA to report product defects or incidents;
    To law enforcement authorities to protect public safety or to assist in apprehending criminal offenders;
    When required by court orders, search warrants, subpoenas and as otherwise required by the law.

Uses and Disclosures of Protected Health Information Requiring Your Written Authorization
Other uses and disclosures of medical information not covered by this Notice or the laws that apply to us will be made only with your written authorization. If you give us authorization to use or disclose medial information about your, you may revoke that authorization, in writing, at any time. IF you revoke your authorization, we will thereafter no longer use or disclose medical information about you for the reasons covered by your written authorization. We are unable to take back any disclosures we have already made with your authorization, and we are required to retain our records of the care we have provided you.

Patient Rights
As our patient, you have the following rights:
    To have access to and/or a copy of your health information;
    To receive an accounting of certain disclosures we have made of your health information;
    To request restrictions as to how your health information is used or disclosed;
    To request that we communicate with you in confidence;
    To request that we amend your health information;
    To receive notice of our privacy practices.

If you have a question, concern or complaint regarding our privacy practices, please notify the doctor.

Occasionally it may be necessary to use an open adjusting room to facilitate immediate adjusting service. You may request that we wait to adjust you until a private room is available.