Online Forms

The following forms are our standard patient intake forms for Core Chiropractic and for your convenience are made available here for download. Please choose all 5 forms from the following list, download and print them off and have them completed in either black or blue ink prior to your firts visit. Thank you!

  • 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 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!

Download & Print Form


Office Financial Policy - Required

Download & Print Form


Health and Insurance Portability and Accountability Act - Notice of Privacy Practice - Required

Download & Print Form


Automobile Crash Form - Required

If you have been involved in a car crash and your condition is related to this accident please additionally fill out the following form:

Download & Print Form



Download the Free AdobeReader®

Office Hours

Our Regular Schedule

Monday:

9:00 am-5:30 pm

Tuesday:

9:00 am-12:15 pm

Wednesday:

9:00 am-5:30 pm

Thursday:

9:00 am-12:15 pm

Friday:

9:00 am-1:00 pm

Saturday:

Closed

Sunday:

Closed

Testimonial

Review By Our Satisfied Patient

  • "Great service! Nice clean office! I love being able to get an appointment fairly quick if I need an adjustment!"
    Anna M. Coeur d' Alene, ID

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