DR. CHANTEL SERACK, D.C.

	Clinic Forms

 

NEW CHIROPRACTIC PATIENT FORM - If you are a new patient, please print off the following form to complete.  Note: This form is designed to be printed double sided if your printer can support double sided printing.  If you are not able to, we will have you fill in the form once you arrive in our office.  FOR ALL NEW PATIENTS, WE ASK THAT YOU ARRIVE AT LEAST 10 MINUTES PRIOR TO YOUR APPOINTMENT.   IF THE APPOINTMENT IS FOR A CHILD UNDER THE AGE OF 10, THERE ARE SPECIAL FORMS TO BE FILLED IN ONCE YOU ARRIVE AT THE CLINIC.  

UPDATE FORM-This applies to anyone who has not been seen in our office for one (1) year or more.  Please arrive 10 minutes early to complete these forms in the clinic. They are not available online.  

CONSENT TO CHIROPRACTIC TREATMENT - It is important for you to consider the benefits, risks and alternatives to the treatment options offered by your chiropractor and to make an informed decision about proceeding with treatment.  Consent forms are available to review and sign when you arrive for your first treatment.