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Chiropractic Associates of Fort Collins offers our patient form(s) online so they can be completed it in the convenience of your own home or 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

The following four forms are required for every patient's first visit.  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!

New Patient Intake Form

Case History

Privacy Policy Please read and print a copy for your records.  *You do not need to bring this document to your visit.

Receipt of Privacy Policy 

Additional paperwork:  If any of these scenarios apply to you, please print and fill out these forms.

Automobile injury?  Please fill out this additonal information.

Assignment, Lein & Release

Automobile Accident Questionnaire

Do you have GreatWest Healthcare?  If so, these three additional forms are required and may need to be updated occasionally.

ACN Patient Information

ACN Neck Index

ACN Back Index

 Are you covered by Medicare?  If so, this additional paperwork is required and will need to be updated annually.

ABN Form




Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! 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!

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