Duncan Chiropractic Health Center, LLC 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!

Other Forms

Demographic Information
Notice of Financial Responsibility/Financial Agreement
Notice of Privacy Practices
Revised Owestry Chronic Pain Disability Questionnaire
Medicaid Coverage for Chiropractic Care
Medicaid Waiver of Non-Covered Services
Motor Vehicle Accident Questionnaire
Re-examination Questionnaire
Pediatric Re-examination Questionnaire
Consent of Treatment/Privacy Notice

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!