New Patient Forms for Lifetime Health and Wellness
Online Intake Form
We now have the option to fill out your paperwork online ahead of your appointment. THIS OPTION IS NOT AVAILABLE USING A MOBILE PLATFORM. Just click the link below to get started. The information will be securely transferred to our system decreasing the amount of time you would normally spend filling out paperwork by hand. Then, all you have to do is to bring in your photo ID and insurance card to your first appointment and sign a few documents. (NOTE: This paperwork is only for new chiropractic patients. CHILDREN AGES UP TO 5 YEARS OF AGE, AUTO, PERSONAL INJURY, WORK COMP., ALLERGY, AND MASSAGE ONLY PATIENTS STILL NEED TO FILL OUT THE HAND WRITTEN FORMS WHICH CAN BE PRINTED FROM OUR LIST BELOW AND FILLED OUT BEFORE YOUR VISIT.)
New Patient Intake Forms To Be Printed and Filled Out By Hand
We understand that your time is precious and there are many things you would rather be doing besides sitting in a doctor's office filling out forms. So, we have put our forms online for you to print and fill out at your leisure. Bring them in for your first appointment and save yourself valuable time. Also, remember to bring in your photo ID and insurance card to your first visit.
- Patients involved in an Automobile Accident
- Patients involved in a Workers Compensation Injury
- New Chiropractic Patients
- Pediatric Patients (0-5 Years Old)
- New Allergy Patients
- New Massage ONLY Patients
If you would like more information about our services feel free to call us at (303) 423-4610
These forms require Adobe Acrobat Reader,
click here to download your own free version.