WARNING

You are using an outdated browser. Please upgrade your browser to improve your experience.

Close [x]

Testimonial

McDuff Chiropractic Center 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.

Instructions:

Please read and complete these forms thoroughly prior to arriving for your exam. Complete all sections even if you feel the questions do apply to you. I have exam gowns for the exam. Or if you wish, bring or wear running/gym shorts and a short sleeve shirt for the exam. You can change clothes here at my office. If you wear contact lenses, please do not wear them for the exam. Contact lenses and regular work clothes are fine for all follow up visits. Your exam will take up to 90 minutes so please plan accordingly. If possible, please return these forms to my office before your exam by mail, email or fax (925) 933-3007.


For Minors:
Please read and complete the Regular Intake Forms in addition to the forms in this section prior to arriving for your child’s exam. Complete all sections even if you or your child does not feel the questions apply.
If possible and when applicable, have your child be a part of filling out the forms, or if capable, have your child complete as much of the forms as possible. I have exam gowns for the exam. Or if you wish, bring or wear running/gym shorts and a short sleeve shirt for the exam. You can change clothes here at my office If you wear contact lenses, please do not wear them for the exam. Contact lenses and regular work clothes are fine for all follow up visits. Your exam will take up to 90 minutes so please plan accordingly. If possible, please return these forms to my office before your child’s exam by mail, email or fax (925) 933-3007.



Download the Free AdobeReader®