New Patient Paperwork
Applied Health Associates 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.
ADULT New Chiropractic Patient Intake Form (age 11+)
Please complete if you are paying cash or using health insurance.
Click to DownloadWORKERS 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.
Click to DownloadMOTOR VEHICLE New Patient Intake Form
Please complete if you were injured in an auto accident.
Click to DownloadCHILD New Chiropractic Patient Intake Form (age 10 and under)
Click to Download
CONSENT TO TREAT A MINOR Form (ages 11 -18)
**Required for Children's Intake forms**
Click to DownloadMASSAGE Intake Form
Please complete if you are only coming in for massage (not chiropractic).
Click to DownloadPRACTICE MEMBER GUIDELINES Form
**Required for ALL NEW PATIENTS!**
Click to Download
OFFICE HOURS
Monday
8:00am - 6:00pm
Tuesday
8:00am - 6:00pm
Wednesday
8:00am - 6:00pm
Thursday
8:00am - 6:00pm
Friday
8:00am - 6:00pm
Saturday & Sunday
Closed
Applied Health Associates
1303 S Grand Blvd
Spokane, WA 99202