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Self Pay Patient (not filing insurance) please use the Manual Paperwork Option by clicking the "Chiropractic" or "Natural Medicine" link below.

Manual Paperwork

      A) Print PDF file on your printer

      B) Fill out with an ink pen before you arrive

      C) Bring filled out documents to you scheduled appointment.

CHIROPRACTIC - New Patient Paperwork

NATURAL MEDICINE  - New Patient Paperwork

Insurance Patient or Auto Accident Patient - please use the "New patient - On Line Paperwork Link" below.  Simply follow the instructions by filling out your name, demographics, etc. click next after you complete each section

This will be easier on your desktop / laptop, but use can use a tablet or cell phone too. Please press "Submit" when you are done, at that time your information will be securely & automatically be sent to server in our office.

IMPORTANT SPECIAL INSTRUCTIONS

Insurance Patient  - "NO CAR ACCIDENT" - If you are NOT receiving treatment due to a motor vehicle accident, then answer

When you come to the reason for your visit section the first question is...What is the main reason for this visit?  Answer PAIN

Once you have completed the first condition section you will be asked if you have another condition.  Please press "Yes" if you have more than one condition (most patients have more than 1) and answer the questions provided for your second condition.  Same question for condition 3 if you have a 3rd condition press "yes" if not click no and move forward through the rest of the intake form.

YES Car Accident -  This is when you will be treated for injuries sustained in a recent motor vehicle accident & have an attorney representing your case. 

When you come to the reason for your visit section the first question is... What is the main reason for your visit? Answer Auto Accident (personal)

Once you have completed the first condition section you will be asked if you have another condition.  Please press "yes" if you have more than one condition (most patients have more than 1) and answer the questions provided for your second condition.  Same question for condition 3, if you have a 3rd condition press "yes" if not click no and move forward through the rest of the intake form.

Click the green link directly below to begin on line paperwork.

New Patient - On Line Paperwork Link

Natural Medicine Patients who have been asked to complete the detailed health assessment questionnaire.

A) Print on your printer

B) Fill out before you arrive

3) Bring your filled out PHA to our office and we can schedule your natural medicine consultation when you drop off the questionnaire..

Click blue link below to see and then print out the PHA form

PHA - Personal Health Assessment