Smith Chiropractic Offices P.C. 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.
• Download the necessary form(s), print it out and fill in the required information.
• Fax us your printed and completed forms or bring them with you to your appointment.

New Patient Information and 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?  Please print all four (4) documents and fax to 970-352-2006 or bring them with you to your appointment.

Click to Download and Print Patient Information Page

Click to Download and Print Case History Page 1

Click to Download and Print Case History Page 2

Click to Download and Print Pain Drawing