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!
Download & Print Patient Intake
Download and Print Informed Consent
Download and Print HIPAA Privacy Notice
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.