DeYoung Chiropractic offers our patient form(s) online so they can be completed 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), fill in the required information.
- Share your completed form by emailing it to: [email protected] or
- Patients without AdobeReader®: Print the completed forms to bring with you to your appointment or fax to 616-281-2502
New Patient Health History Form - Required
This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness that's prompting you to seek Chiropractic Care.
Submit the following form to authorize a Provider or Office to release your medical records to our office.
Specifically, any recent spinal imaging (X-Rays, MRI, etc.).