Aligned for Life Chiropractic offers our patient form(s) online so they can be completed in the convenience of your own home or office.
To save our new patients time, please click on the link below to download the editable PDF of our Adult/Child Health Record. Please complete all the fields, print, sign/date and bring to your first appointment. Thank you!
- 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.
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!
Adult Health Record
Child Health Record (under 15 years old)
You'll need Adobe Reader to view & edit these files.