PDF FORMS FOR YOUR APPOINTMENT

After scheduling a new patient appointment with our Cary chiropractic physicians, please download, print, and fill out the appropriate intake form below before your appointment. You may either email your completed intake or bring it to your appointment.

  • If you’re not able to fill out your intake beforehand our office will have a copy for you. Please arrive 15 minutes early to fill it out.
  • Bring any relevant radiology reports or provider notes with you to your appointment if you have them.
  • Our providers will need to view the area of your complaint during your exam. Please wear or bring gym clothes such as shorts and a t-shirt for your appointments.

 

New Patient Intake Form

Download this New Patient Intake Form and fill it out before your first chiropractic or acupuncture/dry needling appointment at our Cary office.

Pregnant New Patient Intake

If you’re pregnant, download this Pregnant New Patient Intake and fill it out before your first chiropractic or acupuncture/dry needling appointment at our Cary office.

Pediatric Intake Form

Download this Pediatric Intake Form and fill it out before your child’s first chiropractic care appointment at our Cary office. Only use this form if your child is 5 years old or younger. If your child is older than 5, fill out the regular New Patient Intake Form.

Acupuncture and Dry Needling Informed Consent

Review this Acupuncture and Dry Needling Informed Consent before your first acupuncture and/or dry needling appointment at our Cary office. Your provider will discuss the contents and answer any questions you may have before treatment. You will be asked to sign stating you consent to treatment.

Chiropractic Care Informed Consent

Review this Chiropractic Care Informed Consent before your first acupuncture and/or dry needling appointment at our Cary office. Your provider will discuss the contents and answer any questions you may have before treatment. You will be asked to sign stating you consent to treatment.

HIPAA Privacy Policy

Review this HIPAA Privacy Policy before your first appointment at our Cary office. It covers how your protected health information is used and secured. You will be asked to sign stating you have viewed and understand our policy.