ONLINE FORMS

Paschket Chiropractic offers our patient form(s) online so they can be completed in the convenience of your own home or office.

 

Please Note: We do not participate in Blue Care Network or any Medicaids.

However, we do try to make it as easy as possible for our patients to access the care they need.

Please refer to our Payment Options section, or contact us for more information.

If you have trouble viewing any of the documents below, you might not have AdobeReader® installed on your device.

New Patient Health History Form

Required

This form lets us know the history and current state of your health and what questions, concerns, and goals regarding wellness we can help you with.

Steps to complete the forms:

  1. Download and print the appropriate form below.

  2. Fill in the required information.

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

Tel: 810.659.2020 | Fax: 810.659.0310 | Email: paschketchiropractic@yahoo.com

Paschket Chiropractic Clinic | 133 N Cherry St. Flushing, MI 48433

  • White Facebook Icon
  • White Twitter Icon
  • White LinkedIn Icon

© 2017 paschketchiropractic.com all rights reserved