Forms


Intake chiropractic patient forms are available on this page to help make check-in faster and easier. Print and fill out the chiropractic patient forms based upon your situation and bring them with you to your first appointment.

Fill out what you can and we will help you with any questions at your appointment. If you need assistance while at home call the DC Chiropractic Center at 503-585-2585 and one of our support staff will help you.

Injured in an Auto Accident

Print out these 5 Forms

Intake Form

Doctor Lien

HIPAA

Consent Form

Assignment of Insurance

Injured At Work

Print out these 5 Forms

Intake Form

Doctor Lien

HIPAA

Consent Form

Assignment of Insurance

Health Insurance

Print out these 5 Forms

Intake Form

Cash Policy

HIPAA

Consent Form

Assignment of Insurance

Oregon Health Plan (OHP)

Print out these 5 Forms

Intake Form

Doctor Lien

HIPAA

Consent Form

OHP Policy

Medicare

Print out these 5 Forms

Intake Form

Cash Policy

HIPAA

Consent Form

Medicare Policy

No Insurance

Print out these 5 Forms

Intake Form

Doctor Lien

HIPAA

Consent Form

Cash Policy

Let's Get You Feeling Better (503) 585-2585