Intake Forms

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.

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.

**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!