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Online Forms

POWER Chiropractic Clinic 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.

New Patient Health History Form - Required

This lets us know the history and current state of your health. Have questions, concerns, or goals regarding wellness that we can help you with? Let us know!

Please click on the web link below and submit to our clinic electronically. Thank you!

This is the URL to ChiroTouch New Patient Intake Web Page: PLEASE USE ALL CAPITAL LETTERS ON THE FORM
https://www.mychirotouch.com/patientintake/?clientid=PCC0001


New Patient Child Health History Form - Required

This form lets us know the history and current state of health for your child. You can print the form and bring it in to our office during your child's first visit with Dr. Hickel.

/storage/app/media/Child_Intake.pdf



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