Christensen Chiropractic -
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Patient Forms:
 
New Chiropractic Wellness Patient Forms:
(Please print and fill out all of the following forms and bring with you to your first appt, if you are uable to print out the paperwork, we ask that you please come in at least 15 minutes early so that we can stay on schedule.)
 
 
 
 
 
 
 
 
 
 
 
 
 
CONSENT TO TREAT.pdf (PDF — 64 KB)
 
HISTORY OF INJURIES.pdf (PDF — 25 KB)
 
 
 
 
 
 
 

 
 
HIPPA PRIVACY ACT.doc (DOC — 25 KB)
 
 
 


Existing Patient Update Forms:
 
(Please print and fill out both forms and bring to your appt.)
 
 
 
re-exam.doc.pdf (PDF — 240 KB)
 
 
HISTORY OF INJURIES.pdf (PDF — 25 KB)
 
 
 
 
 
 
 
Nutrition Patients Only:
 
*Patients wanting nutrition counseling please fill out the New patient paperwork above as well as the health questionnaire below and bring with you.*
 
 
 
 
 
 
 
 
Auto Accident Patients:
For Auto Accidents, please be sure to bring your police report, claim #, adjuster information etc. to your  first appointment.
 
**Please fill out all of the following forms in addition to the new patient forms above**.
 
 
 
street-diagram.pdf (PDF — 23 KB)