Court House Chiropractic offers our patient form(s) online so they can be completed 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.
Patient History
This lets us know the history and current state of your health.
Chiropractic Case History/ Patient Information
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!
Download & Print
Pain Drawing Form
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!
Auto Claim Questionnaire
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!
PATIENT HEALTH INFORMATION CONSENT FORM (HIPPA)
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!