Wellcare Chiropractic Center offers our patient forms so they can be completed in the convenience of your own home or office, before you arrive to your appointment.
- Download the necessary form(s)by clicking the link, print and fill in the required information.
- Bring these forms with you to your appointment.
- Forms are specific for Chiropractic, Acupuncture, Massage and Ideal Protein
- If you do not already have AdobeReader® installed, Click Here to download.
Chiropractic: (please fill out 1-3)
1) Online Registration (this form is completed online)
2) Financial Policies and HIPPAA Privacy Notice Receipt (as it applies to your current situation). Download and bring this form with you to your appointment. Click here to read the HIPPAA Privacy Notice
3) Complete these Questionnaire forms as they apply to your area of pain. Please download and bring with you to your appointment.
| - Neck Pain | - Upper Extremities (arms/hand) |
| - Low Back Pain (online form) | - Lower Extremities (legs/knees/feet) |
| - Headaches |
Massage: Massage Registration Form
Ideal Protein: Health Profile Form