- (585) 671-9210
New Patient Family Health History Form – Required
This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!
Patient Consent Form (HIPAA Compliance)- Required
This lets us know of your rights as a patient and, in particular, the proper care and handling of your medical and personal information as per the federal Health Insurance Portability and Accountability Act (HIPAA)
Informed Consent to Care Form – Required
This form lets us know that you are aware of the information that the Doctor can share your treatment options with you so you can make the best decision for yourself.
Child Health Survery
In order for us to render pediactric chiropractic services, we will need you to fill out the form below. This forms provides us with information needed to better treat your child. Please call if you have any questions!