New Patient Online Forms
Johnson Chiropractic & Holistic Health Center offers our new patient form(s) online so they can be completed in the convenience of your own home or office.
We have three areas from which to choose forms. Please choose the appropriate forms from one of the three sections below.
Click the links below to download, print, and fill them out. Don't forget to bring them with you to your first appointment!
Chiropractic & Acupuncture New Patient Forms
If you were in an automobile accident, please continue down to the Auto Accident section and print the forms found there.
If you have Medicare, the following form is required:
If you wish to have your records released for any reason you are required to fill out the form below. This includes release to family, other medical facilities, legal representative, etc.
Functional Medicine Forms
1. Functional Medicine Intake Form - these forms will be provided in office.
Auto Accident Patients
These forms are required if you are seeking treatment due to an automobile accident
The following forms are required for auto injury cases.