Forms
Gebhardt Chiropractic offers our patient forms online so they can be completed it in the convenience of your own home or office.
Print the the forms below and fill them out prior to your first visit. If you have any questions regarding these forms please email or call us.
- 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 Introduction Card
This lets us know who you are and prepare your records.
New Patient Health Analysis
This form is to learn about your history and current state of your health.
New Patient Health History and Information
A more specific form for your current condition(s)
Neck and Back Pain Disability Questionnaire
These forms help us rate the severity of your neck or low back pain and track your progress during treatment.
