Office Forms

For your convenience we have included on line forms for our patients. Just click on the form you wish to fill out before your first visit to The Health Connection. If you have any questions please feel free to contact us.

(Click the form below to print)

New Patient Forms For all new patients to our office (Unless injury or accident, please print the form below for injury)
Please have your current health care provider fill out our referral form prior to your massage treatment (bring in with you or have them fax to us)

Accident/Injury Forms For all patients being seen due to an injury/accident
Please have your current health care provider fill out our referral form prior to your massage treatment (bring in with you or have them fax to us)

Re-Exam Form Before your chiropractic re-exam please fill out this form

Children Forms These forms are for chiropractic children patients (ages 5 years or younger)only. If your child is going to be seen for acupuncture please fill out the new patient forms only, not this children form

Referral Form For all patients who are being seen in our office due to an injury or using health insurace, a referral is required to start and continue care

HIPPA