We appreciate and value your time. We realize that our forms can be lengthy and hope to expedite your check-in process by inviting you to join our secured patient web portal where you can create an account and we will send you a link to our forms to complete at your leisure.
If you do not wish to join our web portal, you may click on the links below to complete and print our patient forms. We appreciate you taking time to complete these forms prior to your appointment.
All new patients must complete the Registration Form and the Health History Form listed below. If you are being seen for a neck condition, you must also complete the Neck Pain Form in addition to the Registration and Health History Form. If you being seen for a back condition, you must fill out the Back Pain Forms in addition to the health history and registration form. If you are being seen for a brain condition, it is only necessary to complete the Registration and Health History Forms.
Pediatric patients (12 years old and younger):
All new pediatric patients must have the Registration Form and the Pediatric Health History form completed. It is not necessary to fill out any neck or back forms.
We do update all our forms on a yearly basis, or sooner if you have many changes. If you have not been seen in the past year, we ask that you complete a new Registration Form and Health History Form. If you are being seen for a back condition, we ask that you complete the Back Pain Form in addition to the Registration and Health History forms. If you are being seen for a neck condition, we ask that you complete the Neck Pain Form in addition to the Registration and Health History forms. Again, patients being seen for brain conditions do not need to fill out the Back or Neck Pain Forms.
Please print and bring the completed forms with you on the day of your appointment. Please do not mail these forms.
If you would like to request a copy of your medical records, please contact medical records at 612-863-8223.