New Patient Paperwork

Back to Wellness Chiropractic offers new patient intake forms online that can be quickly printed and completed prior to your appointment! This can save you and your family some time at the office!

• All forms are PDF files. You will need AdobeReader® to view them.
• If you do not already have AdobeReader® installed on your computer,
  Click Here to download.
• Download the necessary form(s), print them out and fill in the required information.
• Bring the necessary form(s) to your appointment.

Please let us know the history and current state of your health. Do you suffer from nagging low back pain, headaches, and/or colds? How about reoccurring sinus troubles, constipation/diarrhea, or acid reflux? Or do you not have any particular health issues but want to increase your overall health in general? How can we help you? Let us know!