Clinton Chiropractic Center
New Patient Forms
HomeAbout UsAbout The DoctorWhat Is Chiropractic?ServicesSmoking CessationMassage TherapyBackpack SafetyNew Patient CenterInsuranceFor Your Information!3D Spine SimulatorKid's Fun Page


We only need one of the "Patient Information" forms,
which ever one that pertains to you. 

click here to download file: Required - Patient Information (Age 5 and over)

click here to download file: Required - Patient Information (Under age 5)


The Privacy Policy is for your information. If you would like to have a copy feel free to print it and keep for yourself. However, we do need you to print and sign the Authorization and Release Form and bring it in with the other required forms.

click here to download file: Required - Authorizations and Release form

click here to download: Privacy Policy


Please bring your Insurance card with you to your first visit so we may scan it into our computer to have in your file so our insurance person will be able to verify your benefits.