Chiropractic Intake Form

The Chiropractic Intake Form helps new patients share their health history, current symptoms, and treatment goals before the first session. It reduces waiting room paperwork and gives your clinic everything needed to start personalized care right away.

You save time, reduce errors, and deliver better patient experiences.

About this template

This form gathers personal info, pain history, medical background, and consent. It’s ideal for chiropractic clinics, wellness centers, and solo practitioners.

Why Use This Chiropractic Intake Form?

Manual forms lead to delays and scattered information. This digital form lets patients fill out their details from home, so you start every appointment with full context.
It also helps your staff stay organized and reduces missed details that could affect care.
Great for new patient onboarding, regular updates, or pre-appointment check-ins.

Smart Features That Help You Prepare Better

  • Collect digital signatures for consent and policies → Enable electronic signature

  • Upload x-rays or previous reports for quick review → Enable file uploads

  • Use conditional fields to uncover symptoms based on body areas

  • Customize branding to reflect your clinic’s identity

  • Export intake data to keep patient files up to date

How to Use This Form

  1. Click Use Template

  2. Add your clinic name, policies, and consent notices

  3. Customize sections for patient details, pain locations, and prior care

  4. Share the form link before the first visit

  5. View submissions in your dashboard to review before sessions

Use this form to streamline your intake process, stay compliant, and give every patient a professional, stress-free start.

Looking for more templates?

Simplify your form creation process with our range of professionally designed form templates. Choose from a variety of styles and designs, including contact forms, surveys, job applications, and more - all available now for free!

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