Online Patient Forms

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Online Patient Forms

ABOUT OUR ONLINE PATIENT FORMS

Our Free Introductory Consultation is a formal conversation about you, your health conditions, your symptoms, your social and medical history and Boulder Chiropractic Clinic’s approach to the diagnosis, prognosis and treatment of your condition(s). Below are the three forms used for the doctor to have the information needed for your Boulder Chiropractic Clinic Free Introductory Consultation and for your Initial Evaluation. Please complete all three of these forms before your first meeting with the doctor:

  1. Patient Information Form
  2. Symptomatology Questionnaire
  3. Social and Medical History Form

Please contact us directly, if for any reason, you have difficulty or questions about meeting our documentation requirement.

IMPORTANT:

THE FORMS HAVE THEIR OWN INDEPENDENT SCROLL MECHANISM WHICH IS DIFFERENT FROM THE SCROLL MECHANISM USED FOR THE WEBSITE PAGE. PLEASE US THE FORM SCROLL BY CLICKING DIRECTLY ON THE FORMS. THIS WILL ALLOW YOU TO NAVIGATE UP AND DOWN THE FORMS, FIND AND ANSWER ALL QUESTIONS AND FIND AND ANSWER ALL QUESTIONNAIRES. OTHERWISE, BY USING THE PAGE SCROLL, YOU MAY NOT FIND THE SYMPTOMATOLOGY QUESTIONNAIRE AND YOU MAY NOT BE ABLE TO ACCESS THE TOP PART OF THE FORMS.