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Online Forms

Arapahoe Chiropractic and Acupuncture Center offers our patient form(s) online so they can be completed 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 form(s) or bring it with you to your appointment.

New Patient Health History Form - Required

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 & Print Form


Informed Consent/Financial Policy Form - Required

Download & Print Form


Health Insurance Claim Form - Required

Download & Print Form


Motor Vehicle Accident Questionaire Form - Required for Auto Accident Patients Only

Download & Print Form



Pain Drawing Form - Required for Auto Accident Patients Only

Download & Print Form


Neck/Low Back Disability Index Forms - Required for Auto Accident Patients Only

Please complete the neck form if you are having neck pain,

Please complete the low back form if you are having low back pain

Download & Print Form


Download the Free AdobeReader®