Online Forms

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Online Forms

Arizona Chiropractic & Holistic Health Center offers our patient form(s) online so they can be completed in the convenience of your own home or 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.

New Patient Intake Form

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 and Print Form

Massage Intake Form

Only getting a massage? This is a shortened form for massage only patients. Please fill out the new patient form if you are receiving other services as well.

Download and Print Form

Personal/Auto Injury Form

If you were involved in a motor vehicle accident, this form is required in addition to the new patient form.

Download and Print Form