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...

What's the difference between sick care and health care?
Sick care is largely about relieving or suppressing symptoms. Health care is about improving performance. While sick care is about how you feel, health care is about how you function. Sick care is what you do to treat an obvious problem, and health care is what you do to avoid the problem and advance your well-being.
How could chiropractic help a stomach problem?
Chiropractic works by locating and reducing areas of the spine compromising nerve communications between your brain and your body. If nerves to or from your stomach are irritated, your stomach won't work right. Chiropractors find the source of the interference, reduce it and allow your body to work as designed.