Active Family & Sports Chiropractic offers our patient form(s) 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.
- Download the necessary form(s), print it out and fill in the required information.
- Fax us your printed and completed form(s) or bring it with you to your appointment.
New Patient Health History Form - Required
This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!
Intake Form - ALL Chiropractic & Acupuncture patients
Consent to Treat Minor (only complete if under 18 years old)
Low Back Pain Form (only complete if you have low back pain)
Neck Pain Form (only complete if you have neck pain)
Headache Form (only complete if you have headaches)
Motor Vehicle Accident Form (only complete if your claims are related to an accident)
Notice of Privacy Practices (Full Document - Informational purposes only)