The Dynamic Health Clinic, also known as "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!

Download & Print Form

New! Patient Health History - Detailed Form 


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

Download & Print in Microsoft Word 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 in Adobe Reader Format

Download in Microsoft Word Format

ABN-Medicare Form

Download & Print Form

Consent to treat a minor Form

Download & Print Form

Motor Vehicle Accident / 3rd Party Liability Form

Download & Print Form

Privacy disclosure Form

Download & Print Form

Terms of Acceptance Form

Download & Print Form 

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