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:
Workers' Compensation Forms
Please complete all of the above New Patient Forms along with the following form:
(Questions 1-16)
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