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Online Forms

Family Healthcare Clinic - Dr. Deborah Brown offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic 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

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


Cancellation Policy/After Hours Treatment Form

Download & Print Form

Patient Information Form

Download & Print Form

Receipt of Notice of Privacy Practices Form

Download & Print Form

Consent for Treatment and Authorization to Perform X-Rays Form

Download & Print Form

Symptoms Form

Download & Print Form

Insurance Policy Notice Form

Download & Print Form

Informed Consent For Chiropractic Care Form

Download & Print Form

Consent for Treatment of a Minor Form

Download & Print Form


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our chiropractic office. You can print the form out and bring it in to our office during your next visit with our chiropractor, or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form


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DayMorningAfternoon
Monday8:30-12 - 6
Tuesday93
Wednesday9-12 - 6
Thursday93
Friday9-12 - 4
Saturdayby appointment
SundayClosedClosed

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