The following New Patient forms are provided for your convenience to make the first office visit a faster process.  You can print out the forms and fill them out as much as possible.  If do not understand any part of the forms, then your questions can be answered when you come in on your first visit. 

Also forms can be given to other family members or friends who you would like to refer into the office. 

New Patient Forms: 

Please Print all forms below and bring completed to first visit.

Confidential Patient Information

Health Report

Health History

Health History 2

HIPAA-Consent for Use and Disclosure

TERMS OF ACCEPTANCE 

New Patient Forms for children 2 years of age and younger:

Pediatric Patient Information

Pediatric health report

Patients under the age of 18.

The following is a minor information sheet for anyone under the age of 18years old.  This is required to be signed by a legal guardian to allow Fetcho Family Chiropractic to administer care.

Minor Information