Parkway Chiropractic offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic office.
- If you do not already have AdobeReader® installed on your computer, Click Here to download.
- Download the necessary form(s), print it out and fill in the required information.
- Fax 318-584-7041 us your printed and completed form(s) OR bring it with you to your appointment.
Once you have become a wellness member, Click Here to register online! Your decision to be proactive in your health will enable you the health benefit of regular chiropractic care and the flexibility of having it come to you. If you have no current complaint use 'Wellness' in place of a complaint.The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!
Download the Free AdobeReader®
It is advised to print the informed consent, intake form, pain drawing, and HIPPA acknowledgment form You should fill out and bring the completed forms to your first visit along with any other chiropractic or imaging records.
INFORMED CONSENT:
/storage/app/media/Informed_Consent_to_Care.pdf
INTAKE FORM (UNINSURED)
/storage/app/media/Initial_Intake_Form_9.16.15V3no_insurance.pdf
PAIN DRAWING:
/storage/app/media/QVAS_PDF.pdf
HIPPA FORMS:
Print and Return:
/storage/app/media/HIPAA_Patient_Acknowledgement_and_Consent.pdf
DO NOT PRINT THIS FORM (Read Only):