New Patient Forms


Personal History Form (click here to fill out this form online):

 

When filling out the Personal History, you will be asked about physical, chemical, and emotional stressors that go as far back as the womb. We believe that whatever goes to the back of your mind goes into the spine, and that the position, tone, and tension of your spine is determined by the past and present stresses in your life and how well you have adapted to these stresses. Stresses in your life may affect the health of your spine and nervous system. The good news is that when your spine changes, your life changes, and on your first visit you will have an opportunity for a happier and healthier spine and life. Do your best at filling out the Personal History form, and the Doctor of Chiropractic will go over it with you on your initial visit.

 

Document to Read:

 

Please read the following. You will be asked to sign that you have read, understood and agree to the following before seeing the Doctor of Chiropractic. If you booked by phone or in the office, you will be asked to sign that you have read, understood and agree to the following before seeing the Doctor of Chiropractic. If you booked online, you will have already checked that you have read and agree:  Informed Consent to Receive Network Spinal Analysis (NSA) Care, Special Notice for Medicare and Insurance Patients, COVID-19 ProtocolNotice of Privacy Practices.

 

Click here to read prior to your first visit:

Informed Consent to Receive Network Spinal Analysis (NSA) Care
Special Notice for Medicare and Insurance Patients
COVID-19 Protocol
Notice of Privacy Practices PDF

 

Current or Returning Patient Forms:

Heal, Vitalize, Love & Live Fully