New Patient Forms

Champion Health offers our patient forms 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 forms from the list below that pertain to your visit, print them out and fill in the required information.
  • Fax them to us or bring them with you on your first appointment.

Chiropractic Patient History (Adult)

Completion of this form helps us to understand your health history and the current state of your health. What questions, concerns or goals regarding your health and wellness can we help you with? Let us know — we’re here to help you!­

Review of Systems (Adult)

Completion of this form helps us to understand the symptoms and conditions that you have so we can formulate the best course of treatment.

Patient History Form (Pediatric)

Completion of this form helps us to understand your child’s health history and the current state of their health.

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