Chiropractic Pre-Care Forms

Please fill out the following applicable form(s) prior to your first visit at Center for Life Chiropractic of Bend, Oregon. We offer online fillable forms and are proud to be paperless!

In order to download the forms, you must have Adobe Acrobat Reader installed on your computer.

PLEASE READ THESE INSTRUCTIONS.
For your convenience, you may fill the form(s) out online and either print the form(s) by saving them to your desktop, or email them to us by clicking on the "email" button. You may only submit the form(s) by email if you have an email program like Outlook installed on your computer (POP3 account). If you use gmail, yahoo, hotmail or another web-based email account, you'll need to 1) fill in the online form(s); 2) select "file", then "save as" and save to your desktop; 3) open your email program as you normally would and attach the completed forms to your email. Email forms to chirofriedy@yahoo.com.

>> Child Care Form

>> Adult Care Form

>> Accident History Form

>> Massage Intake Form

>> Philosophical Agreement Form