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Online Paperwork

We offer our paperwork on line so you can complete it in the convenience of your own home.


Necessary Forms

Health History

Please complete ALL of the forms below and bring them with you to your first appointment.

pdf iconNew Patient Assessment

pdf iconLower Back Assessment 

pdf iconNeck Pain Assessment

pdf iconAssignment of Benefit

pdf iconInformed Consent

Is Chiropractic Right for You?

Optional Forms and Questionnaires

Please complete any of the below assessments that apply to you

OR to Find out if Chiropractic is right for you, please complete the appropriate assessment and email to bartoncreeckchiropractic@gmail.com

pdf iconLower Back Assessment

pdf iconNeck Pain Assessment

pdf iconSleep Quality Assessment

pdf iconShoulder Pain Assessment

pdf iconLower Extremity Assessment

pdf iconHeadache Assessment


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Get adobe readerEach 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.

Call Barton Creek Chiropractic today to make an appointment!