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Commonly used Patient Forms
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Description
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If you would like to save time during your next appointment, please print out and complete the following forms:
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New Patient (If this is your first visit to Santiago Chiropractic Associates or if your last appointment was more than seven years ago)*:
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Case_History (.pdf)
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Case_History part II (.pdf)
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Financial_policy (.pdf)
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Patient_Insurance (.pdf)
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Update Patient (If your last appointment with Santiago Chiropractic Associates was more than 3 months ago)*:
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Case History Update (.pdf)
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Financial policy (.pdf)
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Patient Insurance (.pdf)
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Privacy practices (.pdf)
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Auto Accident (If your complaint is related to an automobile accident and you choose to go through an auto insurance. Note: Please bring your current auto insurance, registration, and health insurance.)
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Case_History (.pdf)
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Case_History part II (.pdf)
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Financial_policy (.pdf)
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Patient Insurance (.pdf)
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Privacy_practices (.pdf)
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Vehicle_Accident (.pdf)
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Health_Survey (.pdf)
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Neck Disability Index (.pdf)
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*Please remember to bring with you your most current health insurance information.
Patients without health insurance are also welcome.
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