ONLINE FORMS

Health Horizons offers our patient forms online so they can be completed at your convenience prior to your initial visit. This lets us know the history and current state of your health. What questions, concerns and goals can we help you with?  Let us know.

Instructions for filling out the Online Chiropractic New Patient Case History

  • Click on the link below for the Online Chiropractic New Patient Case History.
  • Fill in patient's name and address.
  • If you are filling this out for an infant/child, please answer (YES) to the question 'Is this condition associated with a child developmental concern or condition?'  It will then bring up the Pediatric intake questions for you to fill out.
  • Finish filling in your demographics.
  • When it comes to the question 'What is the MAIN reason for your visit?' please use the drop-down arrow to select the option that best pertains to your case type.  If you are coming for an auto injury case, choose (Auto Accident).  It will then bring up questions related to this type of injury.  
  • Finish the rest of the form, sign your name and click submit. 

ONLINE CHIROPRACTIC NEW PATIENT CASE HISTORY