Dewald Chiropractic offers our patient form(s) online so they can be completed in the convenience of your own home or office.
- If you do not already have AdobeReader® installed on your computer, click here to download.
- Download the necessary form(s), print it out and fill in the required information.
- Fax us your printed and completed form(s) or bring it with you to your appointment.
Patient Information & Health History - Required
We are unlike many offices who over book and run late. Out of respect for our patients, we are almost always ON TIME, so when we ask for you to PLEASE ARRIVE EARLY, we would greatly appreciate that you do so, allowing us to spend as much time as possible with your treatment time.
*If this information is not completed prior to your visit we may have to reschedule your appointment.
- ONLINE REGISTRATION -Please be sure to COMPLETE this form online and then press 'SUBMIT'. If you have not spoken with us directly, or requested an appointment by clicking the box to the right, you must do so, so that we know to look for your form.
For the following forms, please print out form, complete, and bring with you to your appointment to save paperwork time and increase your treatment time.
- ASH/CVT/SISC 1st Visit Authorization Packet - In additon if you have ASH, CVT or SISC insurance you must also click the link below to print out the ASH Authorization packet.
- ASH / CVT/ SISC Existing Patient Follow up Re-Exam Forms - If you are an existing patient with ASH, CVT or SISC, please print out these forms needed for your visit to save time.
- PERSONAL INJURY PACKET - If you are a Personal Injury (PI/ Auto Accident/Slip & Fall) patient in addition to the "New Patient Information" above you must also fill out the paperwork & bring it in with you during your visit.
- COLON HYDROTHERAPY