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New Patient Forms

Patient signing paperworkAt Better Life Family Chiropractic, we are excited to help you achieve your Better Life so thank you for taking the time fill out our New Patient paperwork!

Online Intake Forms

Adult Intake

Prenatal Intake

Pediatric Intake

Infant Intake

* When filling out paperwork for another person, such as your child, when it states “Please enter your name and email” please enter the PATIENT’S NAME. There will be a place in the form for the parent or guardian name.

** All patients need to arrive 5-10 minutes before their appointment time to complete registration.

*** If your appointment involves a current CAR ACCIDENT or WORKERS COMPENSATION claim, please arrive 20 minutes early to complete registration.

Better Life Family Chiropractic Forms | (509) 464-0444