New Patient Forms

Healthy Family Chiropractic offers our patient forms online so they can be completed in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Please complete the Online New patient intake Form – click the link below to begin.  (All information submitted is encrypted and secured)
  • Download ALL four 4 forms, fill them out and bring them to your scheduled appointment to save time.  (Can save up to 20 minutes)

New Patient Intake

Click the link below to being our new patient intake.   All information submitted is encrypted and secured.

Completion of this form helps us understand your health history and the current state of your health and wellness.

***Completing this form does NOT create an appointment as a new patient.  Please call the office to schedule your new patient appointment

Consent for Use and Disclosure of Health Information & HIPPA Notice of Privacy

About your Insurance

Consent for Text-Email Notification

Financial Responsibility

Call Us