Patient Forms

New Patient Form


Welcome! If you are planning your first visit to Chan Chiropractic and Massage, we look forward to meeting you! To save time on your first visit, we encourage you to download, print, and fill out our new patient forms below.

If you do not already have AdobeReader® installed on your computer, Click Here to download it now.

  • Download the necessary form(s), print it out and fill in the required information.

  • Complete your forms and bring them in with you to your appointment
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New Patient Intake/Information Forms

This let's us know what's happened, but perhaps more important, where do you want to take your health?
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Motor Vehicle Collision Questionnaire (includes New Patient Forms)

If your health issue is the result of a car accident, we need some additional information. Only fill out the pain disability questionnaires that pertain to your injury.
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Massage Therapy Intake Forms​​​​​​​

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2:00 pm-6:00 pm 8:00 am-12:00 pm
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