{"id":9820,"date":"2019-07-09T10:27:45","date_gmt":"2019-07-09T17:27:45","guid":{"rendered":"https:\/\/staging.chiropractorintempeaz.com\/?page_id=9820"},"modified":"2025-12-19T11:19:20","modified_gmt":"2025-12-19T18:19:20","slug":"patient-forms","status":"publish","type":"page","link":"https:\/\/chiropractorintempeaz.com\/index.php\/patient-forms\/","title":{"rendered":"Patient Forms"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row row_content_width=&#8221;grid&#8221; css=&#8221;.vc_custom_1564372640858{padding-top: 60px !important;}&#8221;][vc_column]<div class=\"mkdf-elements-holder mkdf-one-column mkdf-responsive-mode-768\" ><div class=\"mkdf-eh-item \"  data-item-class=\"mkdf-eh-custom-417425\" data-1280-1600=\"0px 15% 76px\" data-1024-1280=\"0px 10% 76px\" data-768-1024=\"0px 0% 76px\" data-600-768=\"0px 0% 76px\" data-480-600=\"0px 0% 76px\" data-480=\"0px 0% 76px\">\n\t<div class=\"mkdf-eh-item-inner\">\n\t\t<div class=\"mkdf-eh-item-content mkdf-eh-custom-417425\" style=\"padding: 0px 15% 76px\">\n\t\t\t<div class=\"mkdf-section-title-holder mkdf-st-standard mkdf-st-title-left mkdf-st-normal-space \" style=\"text-align: center\">\n\t<div class=\"mkdf-st-inner\">\n\t\t\t\t\t<h2 class=\"mkdf-st-title\" >\n\t\t\t\t<span class=\"mkdf-st-title-light\">Making<\/span> <span class=\"mkdf-st-title-light\">Your<\/span><br \/> <span class=\"mkdf-st-title-bold\">First<\/span> <span class=\"mkdf-st-title-bold\">Visit<\/span> <span class=\"mkdf-st-title-bold\">Easy<\/span>\t\t\t<\/h2>\n\t\t\t\t\t\t\t<h4 class=\"mkdf-st-text\" >\n\t\t\t\tIn hopes of making your first appointment with Reed Chiropractic as smooth and efficient as possible, you can fill out all these patient forms in the comfort of you own home or office.\t\t\t<\/h4>\n\t\t\t<\/div>\n<\/div>\t\t<\/div>\n\t<\/div>\n<\/div><\/div>[\/vc_column][\/vc_row][vc_row row_content_width=&#8221;grid&#8221; css=&#8221;.vc_custom_1564973207372{padding-top: 5px !important;padding-bottom: 20px !important;}&#8221;][vc_column width=&#8221;1\/3&#8243;]<div class=\"mkdf-image-with-text-holder mkdf-image-behavior-zoom \">\n\n\t\t\t<div class=\"mkdf-iwt-image\">\n\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"1200\" height=\"622\" src=\"https:\/\/chiropractorintempeaz.com\/wp-content\/uploads\/2016\/10\/blog-5-e1564020687702.jpg\" class=\"attachment-full size-full\" alt=\"a\" srcset=\"https:\/\/chiropractorintempeaz.com\/wp-content\/uploads\/2016\/10\/blog-5-e1564020687702.jpg 1200w, https:\/\/chiropractorintempeaz.com\/wp-content\/uploads\/2016\/10\/blog-5-e1564020687702-600x311.jpg 600w\" sizes=\"(max-width: 1200px) 100vw, 1200px\" \/>\t\t<\/div>\n\t\t<div class=\"mkdf-iwt-text-holder\">\n\t\t<div class=\"mkdf-iwt-text-holder-inner\">\n\t\t\t\t\t\t\t<h5 class=\"mkdf-iwt-title\" style=\"color: #43d5cb\">New Patient Intake Form<\/h5>\n\t\t\t\t\t\t\t\t\t\t<p class=\"mkdf-iwt-text\" >This form will be securely transmitted directly to our office software once you click submit so there is no need to print it out.<\/p>\n\t\t\t\t\t<\/div>\n\n\t\t\t<\/div>\n<\/div>[vc_empty_space height=&#8221;15px&#8221;]<a itemprop=\"url\" href=\"https:\/\/intake.mychirotouch.com\/?clinic=RCD0001\" target=\"_blank\"  class=\"mkdf-btn mkdf-btn-medium mkdf-btn-solid mkdf-btn-solid-dark\"  >\n    <span class=\"mkdf-btn-text\">New Patient Form<\/span>\n    <span class=\"mkdf-btn-icon-holder\">\n        <span class=\"mkdf-btn-icon-normal\" ><\/span>\n        <span class=\"mkdf-btn-icon-flip\" ><\/span>\n    <\/span>\n<\/a>[vc_empty_space height=&#8221;35px&#8221;][\/vc_column][vc_column width=&#8221;1\/3&#8243;]<div class=\"mkdf-image-with-text-holder mkdf-image-behavior-zoom \">\n\n\t\t\t<div class=\"mkdf-iwt-image\">\n\t\t\t<img decoding=\"async\" width=\"724\" height=\"482\" src=\"https:\/\/chiropractorintempeaz.com\/wp-content\/uploads\/2019\/07\/Auto-Accident-Pic.jpg\" class=\"attachment-full size-full\" alt=\"Auto Accident Neck pain\" srcset=\"https:\/\/chiropractorintempeaz.com\/wp-content\/uploads\/2019\/07\/Auto-Accident-Pic.jpg 724w, https:\/\/chiropractorintempeaz.com\/wp-content\/uploads\/2019\/07\/Auto-Accident-Pic-600x399.jpg 600w\" sizes=\"(max-width: 724px) 100vw, 724px\" \/>\t\t<\/div>\n\t\t<div class=\"mkdf-iwt-text-holder\">\n\t\t<div class=\"mkdf-iwt-text-holder-inner\">\n\t\t\t\t\t\t\t<h5 class=\"mkdf-iwt-title\" style=\"color: #43d5cb\">Auto Accident Forms<\/h5>\n\t\t\t\t\t\t\t\t\t\t<p class=\"mkdf-iwt-text\" >If you have been involved in an Auto Accident please print, fill out, and bring these forms with you prior to your first visit.<\/p>\n\t\t\t\t\t<\/div>\n\n\t\t\t<\/div>\n<\/div>[vc_empty_space height=&#8221;15px&#8221;]<a itemprop=\"url\" href=\"https:\/\/chiropractorintempeaz.com\/wp-content\/uploads\/2023\/11\/Auto-accident-questionnaire.pdf\" target=\"_blank\"  class=\"mkdf-btn mkdf-btn-medium mkdf-btn-solid mkdf-btn-solid-dark\"  >\n    <span class=\"mkdf-btn-text\">Auto Accident Intake Form<\/span>\n    <span class=\"mkdf-btn-icon-holder\">\n        <span class=\"mkdf-btn-icon-normal\" ><\/span>\n        <span class=\"mkdf-btn-icon-flip\" ><\/span>\n    <\/span>\n<\/a>[vc_empty_space height=&#8221;20px&#8221;]<a itemprop=\"url\" href=\"https:\/\/chiropractorintempeaz.com\/wp-content\/uploads\/2019\/07\/SYMPTOM-FORM-2.pdf\" target=\"_blank\"  class=\"mkdf-btn mkdf-btn-medium mkdf-btn-solid mkdf-btn-solid-dark\"  >\n    <span class=\"mkdf-btn-text\">Symptom Form<\/span>\n    <span class=\"mkdf-btn-icon-holder\">\n        <span class=\"mkdf-btn-icon-normal\" ><\/span>\n        <span class=\"mkdf-btn-icon-flip\" ><\/span>\n    <\/span>\n<\/a>[vc_empty_space height=&#8221;35px&#8221;][\/vc_column][vc_column width=&#8221;1\/3&#8243;]<div class=\"mkdf-image-with-text-holder mkdf-image-behavior-zoom \">\n\n\t\t\t<div class=\"mkdf-iwt-image\">\n\t\t\t<img decoding=\"async\" width=\"1258\" height=\"833\" src=\"https:\/\/chiropractorintempeaz.com\/wp-content\/uploads\/2019\/07\/iStock-512912274.jpg\" class=\"attachment-full size-full\" alt=\"Patient forms for release of information\" srcset=\"https:\/\/chiropractorintempeaz.com\/wp-content\/uploads\/2019\/07\/iStock-512912274.jpg 1258w, https:\/\/chiropractorintempeaz.com\/wp-content\/uploads\/2019\/07\/iStock-512912274-600x397.jpg 600w\" sizes=\"(max-width: 1258px) 100vw, 1258px\" \/>\t\t<\/div>\n\t\t<div class=\"mkdf-iwt-text-holder\">\n\t\t<div class=\"mkdf-iwt-text-holder-inner\">\n\t\t\t\t\t\t\t<h5 class=\"mkdf-iwt-title\" style=\"color: #43d5cb\">Additional Patient Forms<\/h5>\n\t\t\t\t\t\t\t\t\t\t<p class=\"mkdf-iwt-text\" >If you have records or x-rays from a previous health care provider, fill out this form and bring it with you to your appointment.<\/p>\n\t\t\t\t\t<\/div>\n\n\t\t\t<\/div>\n<\/div>[vc_empty_space height=&#8221;15px&#8221;]<a itemprop=\"url\" href=\"https:\/\/chiropractorintempeaz.com\/wp-content\/uploads\/2019\/07\/Records-and-X-RAY-Release-Form-2.pdf\" target=\"_blank\"  class=\"mkdf-btn mkdf-btn-medium mkdf-btn-solid mkdf-btn-solid-dark\"  >\n    <span class=\"mkdf-btn-text\">Records &amp; X-RAY Release Form<\/span>\n    <span class=\"mkdf-btn-icon-holder\">\n        <span class=\"mkdf-btn-icon-normal\" ><\/span>\n        <span class=\"mkdf-btn-icon-flip\" ><\/span>\n    <\/span>\n<\/a>[\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1564972954375{margin-bottom: 25px !important;}&#8221;][vc_column][vc_column_text css=&#8221;.vc_custom_1766168346506{margin-right: 50px !important;margin-left: 50px !important;}&#8221;]<\/p>\n<h4>If you need help or have an questions please <a href=\"https:\/\/chiropractorintempeaz.com\/index.php\/contact-us\/\">contact<\/a> us at <a href=\"http:\/\/Tel:1(480)785-1355\">480-785-1355<\/a> or by email at <a href=\"mailto:reedchiroaz@hotmail.com\">reedchiroaz@hotmail.com<\/a><\/h4>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row row_content_width=&#8221;grid&#8221; css=&#8221;.vc_custom_1564372640858{padding-top: 60px !important;}&#8221;][vc_column][\/vc_column][\/vc_row][vc_row row_content_width=&#8221;grid&#8221; css=&#8221;.vc_custom_1564973207372{padding-top: 5px !important;padding-bottom: 20px !important;}&#8221;][vc_column width=&#8221;1\/3&#8243;][vc_empty_space height=&#8221;15px&#8221;][vc_empty_space height=&#8221;35px&#8221;][\/vc_column][vc_column width=&#8221;1\/3&#8243;][vc_empty_space height=&#8221;15px&#8221;][vc_empty_space height=&#8221;20px&#8221;][vc_empty_space height=&#8221;35px&#8221;][\/vc_column][vc_column width=&#8221;1\/3&#8243;][vc_empty_space height=&#8221;15px&#8221;][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1564972954375{margin-bottom: 25px !important;}&#8221;][vc_column][vc_column_text css=&#8221;.vc_custom_1766168346506{margin-right: 50px !important;margin-left: 50px !important;}&#8221;] If you need help or have an questions please contact us at [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"full-width.php","meta":{"_monsterinsights_skip_tracking":false,"footnotes":""},"class_list":["post-9820","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Patient Forms - Chiropractor in Tempe | Reed Chiropractic<\/title>\n<meta name=\"description\" content=\"A convenient way for you to complete any patient intake forms ahead of your appointment. 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