ONLINE FORMS

Rai 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 us your printed and completed form(s) or bring it with you to your appointment.

New Patient Forms – 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!

Please thoroughly read the attached Consent Form before appointment time. Do not sign until your appointment with the doctor.

Adults Form – 13 Years of Age or Older – Download & Print Form

Child Form – 3 to 12 Years of Age – Download & Print Form

Infant Form – 0 to 2 Years of Age – Download & Print Form

Download the Free AdobeReader®