Online Forms

Falls Clinic of Chiropractic 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 Paperwork - 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!

Please download, print, and bring to your New Patient Appointment.

Application for Care
Confidential Patient Case History
Security & HIPAA
Consent for Treatment & X-Rays
Quality of Life Survey

Pediatrics - Patients 12 and under

Pediatric Application for Care
Pediatric Confidential Case History
Parent/Guardian Consent for Minors

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