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New Patient Forms

We offer our paperwork online so you can complete it in the convenience of your own home.

New Patient Intake Form

This lets us know what’s happened, but perhaps more important, where do you want to take your health?


Patient Privacy Policy

This notice describes how medical information about you may be used and disclosed, and how you can get access to this information. Please review carefully.

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Automobile Accident

If your health issue is the result of a car accident, we need some additional information.

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Worker’s Compensation

If your health issue is the effect of an injury at work, this information will help us help you.

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Letter Of No Accident Or Injury

If your care is not the result of an accident or injury, and you will not be submitting your claim to Auto Insurance or Worker’s Compensation, please complete this form.

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Imaging Pregnancy Release

If there is a possibility you may be pregnant, please complete this form so we know how to handle any x-ray concerns.

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A Better Life Chiropractic | (513) 385-2273