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ChiroTime Family Chiropractic offers our patient forms online so you can complete it in the convenience of your own home or office prior to your initial appointment.

  • If you do not already have AdobeReader® installed on your computer, click here to download.
  • Download and print the necessary forms and fill in the required information.
  • Fax us your printed and completed forms or bring them with you to your appointment.


Required New Patient Forms

These forms let us know the history and current state of your health, authorize chiropractic treatment, and communicate our office and privacy policies.

What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Health History FormNeck Disability IndexOswestry Low-Back Pain ScaleInformed ConsentOffice PoliciesPrivacy Policies
Auto accident-related treatment also requires the following form:

Auto Accident
If you are seeking treatment for a minor, please use this form for consent to treat a minor:

Informed Consent for Minors


Massage Therapy

This form will help guide our massage therapists to provide you with the best quality massage care. If this is your first massage therapy session, please take the time to complete this form.

Health Information for Massage Therapy


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form


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Newsletter Signup


Backaches & Sciatica
Headaches & Neck Pain
Wellness Topics
Diet & Nutrition
Exercise & Fitness
Women's Health Issues
Children's Health Issues
Stress Management
Doctor's Announcements

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