Grifall Family Chiropractic offers our patient form(s) online so you can complete 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 let’s 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

New Patient: Medical Records (HIPAA) Form  (Required)

This form describes how chiropractic and medical information about you may be used and disclosed and how you can get access to this information.  Please read carefully.

Download & Print Form

New Patient: Auto Accident Questionnaire

This form gives us deatiled information important to your care following an auto accident.  Please fill this out in addition to the Health History Form seen above.

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 office. You can print it out and bring it in to our office 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!