Forms

Family Health & Sports Injury has provided patients the following forms which can be printed off and filled out prior to coming into the office. On your initial visit into the office, please bring the completed forms with you.

New Patient Information Forms

Information Form
Office Policy Regarding Health Insurance
Chiropractic and Medical Information Disclosure
Informed Consent: Doctor Patient Relationship

For Your Information

Our Promise to Privacy
Interferential Electrical Therapy
Injury Information Sheet
Injury History Form

Medical Forms

Low Back Questionaire
Knee Questionaire
Headache Questionaire
Foot Questionaire
Cervical Spine Questionaire
Shoulder Questionaire

Northland IDD Forms

Release Form
Pain Level Chart
Pain Scale
Low Back Form