Intake Forms

Please click below for appropriate intake form. Please print and fill out form completely and bring with you to your first appointment.

CHIROPRACTIC INTAKE FORMS: Please note: ONLY Chiropractic intake forms are available to fill out in the office if necessary. Please arrive 10 minutes prior to appointment if unable to fill out forms beforehand.

New Client Chiropractic Intake Form

Please click below for appropriate intake form. Please print and fill out form completely and bring with you to your first appointment.

FUNCTIONAL MEDICINE INTAKE FORMS: For the amount of health providers you have, please copy the first page (medical record release) for each health provider that you have. (for example, if you have 3 doctors, copy the first page 3 times and fill out appropriately in order to request medical records from the 3 providers).

Please keep the environment in mind when printing these forms and utilize the “print on both sides” option on your printer if available.

Functional Medicine Intake form FEMALE (.pdf)

Functional Medicine Intake MALE (.pdf)

**NOTE: Please allow a minimum of 24 hours before the initial consultation for Dr. Amy to review your intake form, questionnaires, and medical records. Alternatively stated: Initial consultations may be scheduled a minimum of 24 hours after intake forms are received by the office. Thank you!

Take The First Step Today On Your Journey Back To Health

Maybe you have some questions you’d like to ask before you make a decision on becoming a client. Our office is standing by, happy to answer any questions you have to see whether or not Core Flex Wellness and Chiropractic is right for you.

Schedule FREE Discovery Consultation