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New Patient Forms

Patient handing in formsAt Empower Life Chiropractic, we offer our paperwork online so you can complete it in the convenience of your own home. Please print and fill out the New Patient Intro form, the Consent to Treatment, and either the Adult or Child History forms.

Save Time During Your First Visit

New Patient Review of Systems

Adult Questionnaire

Pediatric Questionnaire

Pregnancy Questionnaire

Progress Exam Questionnaire


Empower Life Chiropractic Forms | (847) 550-4699