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NEW PATIENT FORMS

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All Chiropractic Patients
Intake Form
Patient Request For Personal Records
Laser Consent Form
HIPPA Privacy Act

Chiropractic Patients in Automobile Accidents
Accident History
Roland-Morris Low Back Pain Questionnaire
Neck Disability Index
Revised Oswestry Low Back Pain Index
Rand 36 Health Survey

Sports Physical Forms
Sports Physicals Instruction Letter
Consent to Examination
Pre-Participation Physical Evaluation


Acupuncture
Intake Form

Special Information Documents
Stretches & Exercises
Water Intake
Spinal Nerve Function Chart



Open Monday through Saturday
303-469-0353