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Thacker Chiropractic 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.

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!

Fill-in & Print Form or Print Form Only

Electronic Health Records Intake Form - Required

Fill-in & Print Form or Print Form Only

Authorization to Treat and Promise of Payment - Required

Download & Print Form

HIPPA Form - Required

Download & Print Form

Back Index

Fill-in & Print Form or Print Form Only

Neck Index

Fill-in & Print Form or Print Form Only

Download the Free AdobeReader®

Exclusive Offer

Click below to schedule your appointment!

THIS ---->https://thackerchiropractic.com/online-forms.html

Office Hours

Monday8 - 13 - 6
Tuesday8 - 13 - 6
Wednesday8 - 13 - 6
Thursday8 - 13 - 6
Friday8 - 1Closed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8 - 1 8 - 1 8 - 1 8 - 1 8 - 1 Closed Closed
3 - 6 3 - 6 3 - 6 3 - 6 Closed Closed Closed

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