NOW ACCEPTING NewPatients  >>>  CALL (408) 262-7111 TODAY! 

NOW ACCEPTING NewPatients  >>>  CALL (408) 262-7111 TODAY! 

PREPARE FOR YOUR VISIT

Online PAPERWORK

We offer our paperwork on line so you can complete it in the convenience of your own home. Here are the essential forms we use and why we need them. Contact our San Jose chiropractic office now to schedule an appointment.

FREE AdobeReader®

Each form is a PDF document file.

If you do not already have AdobeReader® installed on your computer, click the Adobe® image below to download for free.

Initial Health Status

This lets us know what’s happened…

HIPAA

(Health Insurance Portability and Accountability Act)

This document explains our obligations regarding the use of your personal information.

Insurance Financial Policy

Informed Consent to Care

Neck Pain Questionnaire

If you are visiting our office because of neck pain, please bring this completed form…

Back Pain Questionnaire

If you are experiencing back pain, this information will help us help you.

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