Adkins Chiropractic offers our patient form(s) online so you can complete it in the convenience of your own home or office. Patient forms are required to be completed prior to your scheduled appointment time. You may arrive 30 minutes early to complete them in office or they are available to print below. New patients are required to complete the top three forms listed below. The paperwork provides the doctors with general information about yourself and your condition.
- 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.
- Please fill out forms as completely as possible, as this will assist us in expediting your care.
New Patient Health History Form - Required
This let's us know the history and current state of your health
Consent to Chiropractic Treatment Form - Required
Progress Evaluation and/or New Condition - Existing Patients Only
For existing patients only. Fill out if you have a new condition or are scheduled for a progress evaluation.
Auto Accident Injury Form - Required for Auto Accidents Only
Fill out if you have been involved in an auto accident only. Please fill out form as completely as possible.
Workers Comp Financial Agreement - Required for Workers Comp Only
This form lets you know the steps that will be taken for your billing
Physicians Report Form - Required for Workers Comp Only
This form gives us your employer information. Only fill out sections 1-3
Records Release Forms
This form is required if you are requesting a copy of your records from our office
This form is required if you would like Adkins Chiropractic to receive your medical records from another office