image

Online Forms

We prefer forms filled out electronically via our OnPatient Portal. If you would like access to do your forms online, please contact the clinic by phone at 541-928-1010, or check your email (invitation may be in spam box).

Advanced 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. Help us help you!

Download & Print Intake Form


Additional Health Questionnaire Forms

If you would like our office to be able to discuss your medical care, insurances or finances with anyone other than yourself, please complete this form:

Family Discussion Consent Form - Download & Print

If you made an appointment due to a motor vehicle accident, please complete this form AND the New Patient Health History Form (above):

MVA Intake Form - Download & Print

If you are making an appointment due to an injury which occurred at work, please complete this form AND the New Patient Health History Form (above):

Download & Print Worker's Compensation Form


Informed Consent Form - Download & Print

Notice of Privacy Practices Form - Download & Print Form

image

Contact Us

Send us an email today!

Our Location

Find us on the map

Office Hours

Monday:

8:00 am-6:15 pm

Tuesday:

8:00 am-6:15 pm

Wednesday:

8:00 am-6:15 pm

Thursday:

8:00 am-6:15 pm

Friday:

8:00 am-6:15 pm

Saturday:

Closed

Sunday:

Closed