Element
Testimonials
Meet the Staff The Clinic
Chiropractic Services Chiropractic Adjustments Selective Functional Movement Assessment Active Release Technique Kinesiology Taping Cupping
Physical Therapy Services Selective Functional Movement Assessment Instrument Assisted Tissue Mobilization Myofascial Release Technique Pilates-Based Rehabilitation Craniosacral Therapy Visceral Manipulation Cupping
Wellness Program
Forms Chiropractic Insurance Physical Therapy Insurance
About Meet the Staff The Clinic Chiropractic Chiropractic Services Chiropractic Adjustments Selective Functional Movement Assessment Active Release Technique Kinesiology Taping Cupping Physical Therapy Physical Therapy Services Selective Functional Movement Assessment Instrument Assisted Tissue Mobilization Myofascial Release Technique Pilates-Based Rehabilitation Craniosacral Therapy Visceral Manipulation Cupping
Element
Wellness & Sports Rehabilitation
Wellness Wellness Program Patients Forms Chiropractic Insurance Physical Therapy Insurance Testimonials

Patient Forms

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Below you will find information and documentation packets for new chiropractic and physical therapy patients.

Please select the packet pertinent to you (chiropractic or physical therapy), fill out and bring the completed forms to your first appointment.

 

Patient Forms

New Patient Chiropractic Paperwork

New Patient Physical Therapy Paperwork

Existing Patient Paperwork (Chiropractic & PT)

Auto Injury Chiropractic Paperwork

Auto Injury Physical Therapy Paperwork

Work Injury Chiropractic Paperwork

Work Injury Physical Therapy Paperwork

Pelvic Floor New Patient Paperwork - Female

Pelvic Floor New Patient Paperwork - Male

Pelvic Floor Existing Patient Paperwork - Female

Pelvic Floor Existing Patient Paperwork - Male

Records Release Form

How To Check Your Insurance Benefit (Out-of-Network)

Consent To Treat Minor

Copy of HIPAA Notice of Privacy Practices

Connect with us!

Hours
AboutConnect
 

Phone: (503)445-7999 • Fax: (503)445-7997

5331 SW Macadam Avenue, Suite 105 Portland, OR 97239

 

OFFICE HOURS

8am - 6pm Monday - Friday • 9 am - 1 pm Saturday

TREATMENT HOURS

7am - 6pm Monday - Friday • 9 am - 1 pm Saturday