NEW PATIENT  |  PATIENT FORMS


CLICK on any form and decide how you would like to complete it:

DOWNLOAD first, then choose an option:
- Complete, save it, then email to us   
- Complete, save it, then print and bring with you
        - Print blank form and complete on paper


These forms are also available in our office. 

 

Chiropractic

What To Expect

Adult New Patient Health History Form 
Pediatric (0-13 yrs) New Patient Health History Form (paper only)
Auto Accident Form  only if applicable   
Worker's Comp Form   only if applicable

 

Acupuncture 

What To Expect

New Patient Health History Form

 

Functional Medicine 

What To Expect

4 New Patient Forms:
Comprehensive Health History Form (Functional Medicine Patients Only)- 22 pages
Metabolic Assessment Form
Detox Questionnaire 
Functional Medicine Informed Consent

Environmental Questionnaire - Initially we do not need this form completed 
Thyroid Questionnaire - Initially we do not need this form completed

 

DOT and Sports Exams

What To Expect

DOT Exam Form (updated 09/10/2016)

Iowa Athletic Pre-Participation Form (only available in print format)