Higley Family Chiropractic

New Patient Forms

Print and fill out ALL of the following forms:

• New Patient Info Form
• General Office Policy
• HIPAA Form
• Lower Back Index
• Neck Index
• Pain Rating Scale

Additional Forms

Print and fill out the following forms, ONLY IF they apply:

• Carpal Tunnel Syndrome Questionnaire
• Yellow Flags Questionnaire
• Lower extremity functional evaluation form
• Upper extremity functional evaluation form