Health Questionnaire

The purpose of our office is to restore and maintain the health of our patients through natural, chiropractic care. We encourage our patients to be an active participant in their care.

Please complete this confidential health questionnaire fully and accurately. The more we know about the overall picture of your health or your child’s health, the better we will be able to help you. If you have any questions, please don’t hesitate to ask our chiropractic assistant for guidance. Please note this form is designed for individuals of all ages.