East West Chiropractic offers our patient form(s) online so you can complete them in the convenience of your own home or office. Just click on the provided links.
1. NEW PATIENT PAPERWORK - Required for ALL new patients; complete #2 as well.
2. INDEX FORMS - Complete for each part of the body experiencing symptoms. This form(s) is required at the new patient exam.
Back Index: https://hipaa.jotform.com/221874939700059
Neck Index: https://hipaa.jotform.com/221876539447065
Hip Index: https://hipaa.jotform.com/221914772979067
Lower Extremity Index (Knee, Ankle, Foot): https://hipaa.jotform.com/222404300910034
3. EXISTING PATIENT RE-ACTIVATION PAPERWORK - For existing patients ONLY; please complete #2 as well
This paperwork is for existing patients returning to the office after more than 3 months away from care.
4. Motor Vehicle Accident, Worker's Compensation & Personal Injury - Complete ONLY if filing a claim; complete #2 as well
Motor Vehicle Accident (MVA) Form: https://hipaa.jotform.com/221883746649067
Workman’s Comp (WC) and Personal Injury (PI) Form: https://hipaa.jotform.com/221914498223054