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First Time Visit Forms

Is it your first Chiropractic visit with me? That means there’s a bit of paperwork that needs filling out before we can start getting you on the road to health. Don’t worry, it’s not much! If you’re coming in for just a regular appointment, you only need to fill out the Confidential Patient History Form. If you’ve been in a car accident and are looking for treatment, please download and fill out both the Confidential Patient History Form as well as the Auto Accident Form below. I’ve tried to make this as easy as possible for you, so each form is only two pages long. Four pages isn’t too bad, right?

If you need any additional information, like questions about auto insurance in South Florida or what to do directly after a car accident, then refer to the Useful Links section!

Some of these files might require Adobe Reader, which can be freely downloaded from Adobe here.

Confidential Patient History Form

Your answers will help me determine if Chiropractic Care can help you! The more information you can give me, the better I can determine the best form of treatment for your condition. Click the button below to download the Confidential Patient History Form!

Auto Accident Form

Have you been in an accident? Looking for Chiropractic care? This form has a few questions that help me decide what sort of treatment you will need to treat your auto injuries. Click the button below to download the Auto Accident Form!

I'm a provider for the following major Health Plans and more!

If you don't see your insurance here, don't worry! Contact me and I'll let you know if I can help!

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