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509-838-2225

Applied Health Associates offers our patient form(s) online so you can complete it in the convenience of your own home or 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.

ADULT New Chiropractic Patient Intake Form (age 11+)- Please complete if you are paying cash or using health insurance

Download & Print Form


WORKERS COMP. New Patient Intake Form - Please complete if we are billing L&I or your company's self insurance for an on the job injury.

Download & Print Form


MOTOR VEHICLE New Patient Intake Form - Please complete if you were injured in an auto accident.

Download & Print Form


CHILD New Chiropractic Patient Intake Form (age 10 and under)-

Download & Print Form


CONSENT TO TREAT A MINOR Form (ages 11 -18) -**Required for Children's Intake forms**

Download & Print Form


MASSAGE Intake Form - Please complete if you are only coming in for massage (not chiropractic).

Download & Print Form


PRACTICE MEMBER GUIDELINES Form -**Required for ALL NEW PATIENTS!**

Download & Print Form


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