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TO PROVIDE CUTTING EDGE QUALITY CARE AS WELL AS EDUCATING AND INFORMING OUR PATIENTS TO ENABLE THEM TO REACH THEIR WELLNESS GOALS

Online Forms

CARE CHIROPRACTIC HEALTH & REHAB offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

CHIROPRACTIC APPOINTMENTS

Download & Print Form: Adult (13 Years of Age or Older) 

Download & Print Form: Child (3-12 Years of Age)

Download & Print Form: Infant (0-2 Years of Age)


MASSAGE THERAPY APPOINTMENTS

Download & Print FormAll Ages

For intake forms for other practitioners in the clinic (ie. , Acupuncture Appointment), please ask the reception staff. 



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