Acu-Chiropractic Wellness Center, PA offers our patient form(s) online so they can be completed 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.
- Our fax number is: (651) 454-4375
New Patient Health History Forms
Patient Intake- If you are new to the office please print and fill out these forms a bring to your first visit.
Required for a new injury or if you have a lapse of treatment over 30 days.
Subjective Complaint (just fill in bottom portion in page)