Forms for Adult and Children Patients

Please download, print, and complete the following forms and bring them with you on your first visit. If you have a child who receive chiropractic care, please complete the forms for children in addition to the adult forms. Thank you!

Adult Patient Forms

Adult Welcome Form
Download

General Function Capacity Questionnaire
Download

Fee Schedule
Download

Lifestyle Rating Scale
Download

Low Back Pain and Disability Questionnaire
Download

Neck Disability Scale
Download

Patient History
Download

Privacy Notice
Download

Children Patient Forms

Children's Consent Form
(For children ages 18 and under)

Download

Children's Health and Wellness Intake Form
(For children ages six and under)

Download