Online Forms

Wathan Chiropractic 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.
• Please bring your Insurance card or cards and a photo ID to your first appointment. 

New Patient Form- Required

This paperwork 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!

HIPPA Form

Health Insurance Portability and Accountability Act, a US law designed to provide privacy standards to protect patients' medical records and other health information provided to health plans, doctors, hospitals, and other health care providers.  There are 2 pages to this form, both can be downloaded and printed below. 

Download & Print Form

Consent to Treat Minor Child

For any child under the age of 18, the Doctor's of Wathan Chiropractic have to have the consent of a parent, adult sibling, legal guardian, or an adult who has been given authority to consent in writing to treat a minor child. Below the consent to treat a minor child form can be downloaded and printed.

Download & Print Form