The Federal Way Chiropractor to see - Chiropractor Federal Way

New Patient Forms

To save you time please fill out our new patient forms at home before you come for your first visit.  Please select and print out the type of paperwork that best fits your situation.  Fill out the forms with as much detail as possible.

Cash

1.  Confidential Patient Form
2.  Health Questionnaire
3.  Office Fees and Financial Policy
4.  Terms of Acceptance

Health Insurance and Medicare

1.  Confidential Patient Form
2.  Health Questionnaire
3.  Low Back Questionnaire (if less than 4 weeks)
4.  Low Back Questionnaire (if more than 4 weeks)
5.  Neck Pain Questionnaire
6.  Office Fees and Financial Policy
7.  Terms of Acceptance

Personal Injury and Auto Accidents

1.  Confidential Patient Form
2.  Health Questionnaire
3.  Auto Injury Questionnaire
4.  Accident Injury Questionnaire
5.  Low Back Questionnaire (if less than 4 weeks)
6.  Low Back Questionnaire (if more than 4 weeks)
7.  Neck Pain Questionnaire
8.  Office Fees and Financial Policy
9.  Terms of Acceptance

Work Injury

1.  Confidential Patient Form
2.  Health Questionnaire
3.  Accident Injury Questionnaire
4.  Low Back Questionnaire (if less than 4 weeks)
5.  Low Back Questionnaire (if more than 4 weeks) 
6.  Neck Pain Questionnaire
7.  Office Fees and Financial Policy
8.  Terms of Acceptance

Free AdobeReader®

Each form is a PDF document file.  If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.