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Cole Chiropractic Clinic offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic 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.

For your convenience our forms can be electronically filled out or printed and brought in so that you have a minimal check in time on the day of your visit.

To send your forms electronically: 

  • Select the form(s) that you will be filling out. (the form will open up in a new tab)
  • Fill out the form(s). 
  • After you have completed the form(s), save the document to your computer. (to do this, right click and select Save as...)
  • Save the form(s) onto your desktop or wherever you prefer. 
  • After you have saved your forms, fill out your name below. 
  • Choose the files that you have saved on your computer. (you will need to select open after selecting the form)
  • Once you have chosen the file(s)/form(s), click submit. 

New Patient Data Form 

Download & Print Form


Patient Intake Form

Download & Print Form


HIPAA Form

Download & Print Form


Submit Your Forms Online!

Already completed your forms? Please upload and submit your PDF patient form(s) by filling in the fields below and submit in .pdf format. Find instructions on how to submit your PDF above.