Online Forms

Alexander Chiropractic offers our patient form(s) online so they can be completed 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 or scan and email us your printed and completed form(s) or bring it with you to your appointment.

New Patient Paperwork - 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!

New Patient Paperwork - PDF format

Pediatric Health HistoryPDF format

After completing the New Patient Paperwork, please scan and email the completed form to [email protected] or bring it with you to your appointment. Thank you!

Text Messaging Consent Form - Optional

If you would like to be able to send and receive text messages with Alexander Chiropractic for appointment reminders and changes, please complete the form below and bring it with you to your next appointment. Thank you!

Click on the form below in either MS Word or PDF format to download your copy.

Text Messaging Consent Form - MS Word format
(form can be completed electronically and saved in Word)

Text Messaging Consent Form - PDF format
(form can be printed and filled out on paper)

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