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

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

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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.