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New Patient Forms

New Patient Intake Forms

To save time at your first visit, complete the appropriate intake form before arriving. Choose the form that best matches your age or care needs. If you’re unsure which to fill out, contact our office for guidance.

Chiropractor performing an activator tool adjustment on a patient during a chiropractic treatment session
Adult Patient

For adults seeking chiropractic care. Includes health history, current concerns, and consent for treatment.

Chiropractor providing gentle infant chiropractic care to a baby patient in a calm clinical setting
Pediatric Patient (0-10)

For infants and young children. Covers birth history, development, and current health concerns.

Chiropractor providing gentle neck care to a pediatric patient during a chiropractic visit
Pediatric Patient (11-17)

For older children and teens. Includes relevant medical history and current symptoms.

Chiropractor providing gentle prenatal chiropractic care to a pregnant patient in a comfortable treatment room
Pregnant Patient

For expectant mothers seeking chiropractic care. Centers pregnancy-related health and goals for care.