Phelts 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.
New Patient Health History Form - Required
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!
Gastrointestinal Health Form- Optional
Do you have digestive, stomach, or intestinal problems? Fill out this form if you wish us to assess and prescribe natural remedies for you condition.
Fax form to us at (866) 526-3554 so that we may have a chance to review it before your appointment.
Adrenal Stress Form- Optional
If you feel chronically stressed and tired, and have trouble falling asleep, fill out this form. You may have adrenal gland dysfunction. Your adrenal glands are the organs that help your body regulate stress. If you are constantly under a high level of stress they can "burn out" leading to a myriad of problems.
Member Wellness Registration Form - Optional
This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!
Download & Print Form
Download the Free AdobeReader®