- Contact Us
- We established a good communication with every client we have. Call us today!
Harrah Chiropractic offers our patient form(s) online so they can be completed it in the convenience of your own home or office.
- If you do not already have Adobe Reader® 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 lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!
New! Patient Health History - Detailed Form
DO NOT FILL OUT UNLESS TOLD TO DO SO
This new form is very detailed so to review this file and fill it out, click on the appropriate link below.
Download & Print in Adobe Reader Format
Eating Practices For Optimal Health
Vitally Important information to help guide you to Optimal Health from your Eating Habits...
Download this information below.
Download & Print Form
Consent to treat a minor FormDownload & Print Form
Personal Injury & Workers Comp FormDownload & Print Form
Privacy disclosure FormDownload & Print Form
Terms of Acceptance FormDownload & Print Form
Member Wellness Registration Form - Optional
This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!Download & Print Form
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