Patient Forms

You Can Submit Your Paperwork Online!!!
Save Time! Complete forms before your Appointment!

The best way of doing your intake paperwork is by submitting your information by a secure online form.

This online form is extensive and requires about 20 minutes to complete. The more detailed and complete you are in filling out the form, the more efficient your appointment will be. Do Not use the backspace key to move backwards in the form, it will delete all your input. At the end of the form be sure to click the Submit button. Get started by clicking the link below.

Click Here For Online Form

Problem Detail Form - For Returning Patients
If it's been more than three months since we've seen you or if you have a new condition, please download and complete this form in detail. Use only one form for each problem you are having. For instance, if you have been having a neck and a low back problem, fill out individual forms for each of these problem areas.

All New Patient Packet

Auto Injury Questionnaire
If you are seeking treatment for injuries sustained in an automobile accident, please download and complete this form. The form also contains important information on the documents you need to bring to the office.

Patient Insurance Form

United Healthcare and Great-West Patients
If you have one of these two plans you may be required to fill out a special form required by your insurance carrier. These forms include a Patient Health Questionnaire, Neck Index and Back Index. All patients with these plans should fill out the Patient Health Questionnaire. Each patient should then choose the appropriate Neck or Back Index.  You can fill out both forms if your problem extends to both areas of your spine.

Problem Detail Form