Medical and Health History Form - Chiropractic

The Medical History and Health History are very important documents for the initial patient visit. Most
patients dislike filling out forms when they arrive and sometimes they do not bring all the necessary
information with them. By completing this form before they arrive, not only do they save both the practice and themselves some time, the doctor also has the necessary information to meet documentation
requirements for Review of Systems and Health History.

The information on this form helps the provider correctly assess the patient’s condition and appropriately
review concurrent conditions which may contribute to their reason for the encounter.

Download Forms:

• Medical Health History Form - PDF
• Medical Health History Form - Docx