Valley Chiropractic offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic 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 Forms - Required
These let us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know! All of the following forms are required for new patients.
- Welcome - Download & Print
- Intake Form - Download & Print
- Informed Consent Form - Download & Print
- Assignment of Benefits - Download & Print
- Financial Policy Agreement - Download & Print
- HIPPA Policies - Download & Print (information only, nothing to fill out)
Automobile Accidents and Worker's Compensation
These forms only need to be filled out if you have been in a car accident or had an injury at work.
Welcome Back Form
If we haven't seen you for more than 6 Months - Download & Print