Online Admitting Paperwork

We offer our paperwork online so you can complete it in the convenience of your own home. Call us or Click here to email us your questions!

Health History

This lets us know what’s happened, but perhaps more important, where do you want to take your health?

Chiropractic Intake Form

Download & Print Form

Massage Intake Form

Download & Print Form

Automotive Accident History Form

Download & Print Form

Forms for Child Patients

0-2 Month History

Download & Print Form

2 Month – 2 Year History

Download & Print Form

2 – 5 Year History

Download & Print Form

Free AdobeReader®

Each form is a PDF document file. If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.

Providing Quality Chiropractic Care to Mesa, East Mesa and Apache Junction