New Patient Paperwork

Shields 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.

Download & Print Disability Questionnaire Form – Required

Download & Print Family Health History Form – Required

Download & Print Patient Information Form – Required

Download & Print HIPAA Form – Required

Download the Free AdobeReader®