Westenhaver 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.
- Please bring in your completed forms 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! Please download and print each of these links below.
Please select the following forms below to match your situation - Please choose only one bolded section below.
General Insurance and Self Pay forms - Please print these forms in addition to the intake forms if we will be billing your general health insurance or you will be paying out of your pocket for all services rendered.
Medicare Forms- Please print the following forms out in addition to the intake forms if we will be billing Medicare for you.
Workers Compensation Form - Please print the following forms out in addition to the intake forms if we will be billing a work compensation insurance for you.
Auto Accident Form - Please print the following forms out in addition to the intake forms if we will be billing for an auto accident for you.
Massage Therapy Paperwork- Please print the following forms out if you are coming to our office for massage therapy.