New Patient Forms
All new patients will fill out at brief health intake form.
You will save time and effort if you are able to fill out the form before your first visit.
We have different forms based on your problem.
Choose the appropriate form below, print, and bring it with you.
​Please fill the form out as completely as possible.

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Print & Complete Before Your 1st Visit

Adult Form

Adults (18 years or older) seeking chiropractic care, scoliosis, knee pain or shoulder pain treatments, and/or SoftWave TRT.

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Child Form

Children (0-17 years) seeking chiropractic care or scoliosis treatment.

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Neuropathy

​Adults seeking care for neuropathy treatment.

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autoimmune

​​Adults or children seeking care for:
-Fibromyalgia
-Type 2 Diabetes
-Rheumatoid Arthritis
-Lupus
-Thyroid conditions including Hashimoto's and Grave's

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Gut health

​Adults or children seeking care for diagnoses such as IBS, Crohn's, ulcerative colitis, leaky gut, and/or conditions such as constipation, diarrhea, abdominal pain, bloating, bloody stool, food allergies, sensitivities, or intolerance

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