Welcome to Reed Chiropractic! In hopes of making your first appointment as smooth as possible, we have created a new patient intake form for you to fill out online, in the comfort of your own home or office. All of your information is secure, so rest assured your information is safe and can not be seen by anyone but our staff. Filling out the intake form online will save you time on your first visit, so there will be no need for you to arrive early for your appointment.

Please fill out the New Patient Intake Form online by clicking on the clipboard icon below, and also print the Terms of Acceptance and HIPAA forms and bring those with you on your first office visit. If you do not have access to a printer, we will give you these two additional forms to fill out when we see you.

New Chiropractic Patients FormsNew Patient Intake Form

Please fill out this form to let us know your contact information and health history.

 

 

Terms of Acceptance - Online FormTerms of Acceptance Form

Please print and fill out this form to accept our terms.

 

 

Health Care Authorization Form - HIPPA
HIPAA Health Care Authorization Form

Please print and fill out this authorization form.