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Treatment Inquiry

Name*
First Last
Phone*
Please leave us a number where you will pick up, or we have your permission to leave a message.
Email*
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Requesting Treatment for:*
- Neck Pain
- Whiplash
- Back Pain
- Headaches
- Athletic Injury
- Auto Accident (new)
- Work Injury (new)
- Spa Massage
So we can help you better, please describe your primary issue, how long, how severe, etc. Don't hesitate to tell us insurance details - we can handle it!
You are Requesting:*
- Chiropractic Care
- Chiropractic Rehabilitation & Exercise
- ShockWave Therapy
- Other
So we can help you better, please describe your What type of care you are seeking.
Onset or Problem - This is a:*
- Flare up of an Old Problem
- New Problem, Daily activities (not work)
- Chronic Low Level care need
- Car Accident (new, not old one)
- Work Injury (new, not old one)
- Wellness, No problems or Issues
We need to focus on your care and needs.
Which Clinic location are you requesting?*
- 1934 NE Broadway, Portland
- 5118 SE Powell, Portland
Appointments are made for only one clinic.
Payment/Insurance*
- Self-Pay Discount (not for Medicare)
- Private Insurance - Providence
- Private Insurance - Kaiser
- Private Insurance - PacificSource
- Private Insurance: Blue Cross (which one?)
- Private Insurance: Other
We want to make sure we can accomodate you. We cannot see Medicare, Medicaid, or Oregon Health Plan at this time.
Date of Birth*
Month
Day
Year
Some details, please!*

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Blue Heron Chiropractic

1934 NE Broadway
Portland, Oregon
(503) 280-9759

Hours

Mon 9 am- 6:30 pm
Tues 12 pm - 6:30 pm
Weds 9 am- 6:30 pm
Thurs 12 pm - 6:30 pm
Fri 9 am- 5:30 pm
Sat 10 am - 2:00 pm

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Discover

Treatments
Payment & Insurance
Frequently Asked Questions
Physician Referrals
About
Chiropractic Care
Back Pain
Wellness
Functional Living
Neck Pain
Acute Pain

Blog

Pain Relief with Focused ESWT Shockwave Therapy in Portland at Blue Heron Chiropractic
February 13, 2025
CalGuard and UltraK2: A Powerful Duo for Bone and Cardiovascular Health
February 3, 2025
How Chiropractic helps with Sciatic Nerve Compression
January 30, 2025
Understanding “Double Crush” Syndrome in Nerve Injuries and How Chiropractic Treatment Can Help
November 5, 2024
Relieve Frozen Shoulder Pain with Shock Wave Therapy (ESWT) at Blue Heron Chiropractic
November 3, 2024

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