Aurora Central Chiropractic offers our patient form(s) online so they can be completed it 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.
NEW PATIENT PACKET
New Patient Health History Form - Required
This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!
New Patient Informed Consent Form - Required
These are the services that may be preformed during your visit. If you have any questions we will be happy to discuss them during your visit.
New Patient Privacy Policy Form - Required
This is the HIPPA privacy policy form stating that we will not give out your information without expressed consent per Federal Law. HIPPA Policy is online for you to read.
New Patient Payment Agreement - Required
You agree to pay for your treatment either "at the time of service" or your portion of your co-insurance or co-pay. Also to release records to your insurance company if required.