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EXCLUSIVE OFFER, NEW PATIENTS RECEIVE FREE CONSULTATION.

Online Forms

Back To Health Chiropractic Clinic 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.

  • 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.

Subjective Complaint

Download & Print Form


Policy and Patient Information

Download & Print Form


Patient Signature

Download & Print Form


Financial Policy

Download & Print Form


Insurance Verification Worksheet

Download & Print Form



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