HealthMatters Chiropractic offers our patient form(s) online so they can be completed it in the convenience of your own home or 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.
HIPAA complian Release of Records request form. Print and email or fax back. Complete the left side to have records sent to HealthMatters from another facility or ...Complete the Right side to have your records sent from HealthMatters to another facility or doctor, or for your own use (Fees may apply).
HIPAA Privacy and Financial Forms
Other New Patient Forms
Chiropractic / Acupuncture New Patient Health History Form - Required!
This form can be filled out to prior to your visit at our office. Just print it out and bring it in on your first visit. We look forward to making your experience with our office and website more interactive and rewarding!
You may also download a copy of our HIPAA privacy practices, and Financial practices
Nutritional Counseling New Patient Form
All Nutriton patients must complete either a Chiropractic New Patient History form (above) or this abreviated Nutrition History form. If you are considering both types of care please complete the Chiropractic form. We look forward to making your experience with our office and website more interactive and rewarding!
Nutritional Counseling Nutrition Questionnaire - Optional
If you are coming to the office for full Nutiritonal Counseling (consultation and testing) you will likely need to comple the followig questionaire. As always, you are welcome to do this in our office, but you may also get a jump start by printing the form now at home.
Supplement tracking form - Optional
Sometimes it is helpful to track which suplements you are taking on a daily basis by using the attached form. This gives the doctor a better idea of you current, or amended, supplement use level.