Clark Chiropractic Centre 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.
- Fax us your printed and completed form(s) or bring it 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!
Adjusted America Registration Form
This form can be filled out to register for Adjusted America Membership. This program is the cash plan for those patients in our office that have little or no insurance coverage. We are striving to make wellness care affordable and available to all.