New Patient Paperwork

Excellence In Health Chiropractic & Rehabilitation Clinic offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • All forms are PDF files. You will need AdobeReader® to view them.
  • If you do not already have AdobeReader® installed on your computer,
    Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Bring the necessary form(s) to your appointment.

All New Patient Forms

Please read and fill out each of the following forms prior to your visit. Proceed to the next sections if your visit has to do with a personal injury or Workers' Compensation.

  • New Patient Paperwork - Chiropractic

    Click to Download

  • New Patient Paperwork - Massage

    Click to Download

  • Application For Care

    Click to Download

  • Demographics

    Click to Download

  • Financial Policy

    Click to Download

  • Adams Radiology Release

    Click to Download

  • X-Ray Consent

    Click to Download

  • Pain Diagram

    Click to Download


Personal Injury Forms

Please complete all of the above New Patient Forms along with the following form:

  • CAD Form

    Click to Download


Workers' Compensation Forms

Please complete all of the above New Patient Forms along with the following form:

(Questions 1-16)

  • Physicians Report

    Click to Download

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Monday
8:30am - 6:30pm


Tuesday
8:30am - 6:30pm


Wednesday
8:30am - 6:30pm


Thursday
8:30am - 6:30pm


Friday
8:30am - 6:30pm


Saturday
9:00am - 5:00pm


Sunday
Closed

Monday
9:00am - 7:00pm


Tuesday
9:00am - 7:00pm


Wednesday
9:00am - 7:00pm


Thursday
9:00am - 7:00pm


Friday
9:00am - 7:00pm


Saturday
9:00am - 5:00pm


Sunday
Closed

Excellence In Health Chiropractic & Rehabilitation Clinic

2008 E Northern Lights Blvd #100
Anchorage, AK 99508

(907) 562-6325