Online Forms

Touch of Life Chiropractic offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic 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.

All New Patients - Please fill out the forms below

Patient Case History Form - Download & Print Form

Functional Rating Index - Download & Print Form

Patient Consent Form - Download & Print Form

HIPAA/ Assignment of Benefits - Download & Print Form

Auto Accidents

Accident Injury Questionaire - Download & Print Form

Letter of Protection - Download & Print Form


Pediatric Questioniare - Download & Print Form

Download the Free AdobeReader®