Online Forms

Equilibrium Chiropractic LLC offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic office.

  • 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 Form

NEW PATIENT AUTHORIZATION FORM - required

Download & Print Form

INSURANCE POLICY FORM - required

Download & Print Form

DOT PHYSICAL FORM

Download & Print Form

HIPPA PATIENT FORM (FOR YOUR personal RECORDS)

Download & Print Form