Allen Family 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.
New Patient Health History Form - Required
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 Pediatric Intake Form - Required under age 12
This lets us know the history and current state of your child's health. Please fill out the first three pages, so we can begin a wellness plan for your whole family.
Please be aware a 12 hour cancellation notice is required. A $35 late, cancellation, or no show fee may be charged. Late arrivals may also be subject to this fee.