Welcome to Pro Health & Rehab Chiropractic! To ensure we provide you with the best possible care, we have created a set of intake forms for new patients. Completing these forms prior to your appointment helps streamline your visit and gives our healthcare team the necessary information to understand your health history and current concerns.
Why Complete Our Intake Forms?
Filling out the intake forms allows us to:
- Learn about your medical history, current symptoms, and any past treatments.
- Identify specific areas of discomfort or concern.
- Customize your chiropractic care plan based on your unique needs.
- Gather information related to any recent auto accidents to ensure you receive appropriate care.
- Save time during your initial visit, allowing us to focus more on discussing your treatment options and goals.
Available Forms in English and Spanish
We have created four versions of our intake and auto accident forms to better serve you:
- New Patient Health History Form (English) – This form gathers detailed information about your medical history, including past injuries, surgeries, medications, and general health concerns.
- Formulario de Historia de Salud para Nuevos Pacientes (Español) – Este formulario recopila información detallada sobre su historial médico, incluidas lesiones pasadas, cirugías, medicamentos y preocupaciones generales de salud.
- New Patient & Auto Accident Form (English) – This combined form includes all the information from the new patient health history form as well as additional details related to any recent auto accident injuries you may have experienced.
- Formulario de Nuevo Paciente y Accidente Automovilístico (Español) – Este formulario combinado incluye toda la información del formulario de historial de salud para nuevos pacientes, así como detalles adicionales relacionados con cualquier lesión reciente por accidente automovilístico que haya sufrido.
Forms
- Download the Forms: Click the links below to download the forms in PDF format.
- Print and Fill Out the Forms: After downloading, print out the forms and fill them out as accurately as possible. If you have any questions while completing the forms, feel free to reach out to our team for assistance.
- Bring the Completed Forms to Your Appointment: Make sure to bring the completed forms with you to your initial visit. This helps us provide you with timely and personalized care.
What to Expect During Your First Visit
During your initial consultation, our chiropractors will review your completed forms, perform a thorough examination, and discuss any concerns or symptoms you may have. From there, we will create a customized treatment plan that addresses your needs and goals.
Contact Us
If you have any questions about the intake forms or need assistance, please contact our office at 770-439-9355. We look forward to helping you achieve your health and wellness goals!