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Proactive Chiropractic and PT offers our patient form(s) online so they can be completed it 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 email us your printed and completed form(s) or bring it with you to your appointment. If you have not completed the necessary forms, please arrive 30 minutes before your appointment time.​

New Patient Health History Form - *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! Please download the forms that apply to which type of provider you will be seeing.

NEW CHIROPRACTIC PATIENTS

NEW PHYSICAL THERAPY PATIENTS (WITH NON-MEDICARE INSURANCE)

NEW PHYSICAL THERAPY PATIENTS (WITH MEDICARE PRIMARY INSURANCE)

Member Wellness Registration Form - *Optional*

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form



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