Online Forms

Health Goals Chiropractic & Wellness Center offers our patient form(s) online so you can complete it in the convenience of your own home or office.

• If you do not already have AdobeReader® installed on your computer, Click Here to download.
• Click on each link, 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 Forms - Required

This let’s us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Please click on each link. Make sure to print them out & fill them out by hand. Be sure to bring the papers with you to your first visit in our office.

Patient Intake Form

Privacy Policy

Financial Policy

Assignment

Returning Patients - Update Form - Required

Patients who have been in to see us for 6 months or more, need to complete this form and bring it in with them on their next visit.

Update Form

**Please be as specific as possible when filling out this form.

Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!