Online Forms

$60 Off Your Initial Nutrition Visit

The Natural Health Improvement Center offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic 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 us your printed and completed form(s) or bring it with you to your appointment.

New Patient Forms

Chiropractic Adult

Application for Care
Signature Form

Chiropractic Child

Child Intake Form
Signature Form

Chiropractic Pregnant Mothers

Adult Intake Form
Pregnancy Intake Form
Signature Form

Nutrition Response Testing

New Patient Introduction Form

HIPAA Notice of Private Practice

HIPPAA For Your Information

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