The Marysville Chiropractor to see - Chiropractor Marysville

New Patient Paperwork

We offer our paperwork on line so you can complete it in the convenience of your own home. Here are the essential forms we use.

Adult New Patient Forms

New Patient Intake - Female

New Patient Intake - Male

 

Pediatric New Patient Forms

Pediatric New Patient Information

Infant History Form

Preschool New Patient Information

School Age Child History Form

Consent to Treat a Minor Form

Medical Doctor Referral

HIPAA Notice

New Patient Registration & History

 

Auto Accidents

If you have been in a car accident recently, please fill out these forms as well:

Accident Injury Form

 

Insurance

Insurance Questionnaire

If you have United Healthcare, Great West, Nationwide or Golden Rule, your insurance company requires you to fill out additional paperwork. Please print and complete these forms.

Patient Health Questionnaire - PHQ

 

Free AdobeReader®

Each form is a PDF document file.  If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.

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Drs. Cooper Asks some important questions of interest to Marysville residents - Chiropractor Marysville Drs. Cooper Asks...

Why does chiropractic work?
Chiropractic works because your nervous system, consisting of your brain, spinal cord and all the nerves of your body, controls and regulates every cell, tissue, organ and system of your body. A chiropractor locates and reduces areas of nervous system compromise (usually along the spine) so your capacity to heal is restored. Chiropractic works by helping your body work as it was designed.
What is the purpose of pain?
Pain prompts many Marysville folks to begin chiropractic care. But pain isn't the problem! Pain is just how your body alerts you that a limit has been reached (or exceeded), that something isn't working right and that some type of change is needed. As a chiropractor, my job is finding the underlying cause and recommending the changes needed to bring your body back into balance.