Back to Health Chiropractic & Natural Health Care offers our patient form(s) online so they can be completed it in the convenience of your own home or 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 Health History Form - General
This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!
New Patient Health History Form - Worker's Compensation (or) Personal Injury
This lets us know the history and current state of your health. Be sure to thoroughly fill out the information regarding where, when, and how your accident/injury occurred. Let us know!
(If you are under 18 years old, additional form will be made available to you upon your arrival at our office).