Online Forms

Rapp Chiropractic offers patient forms 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 fill out forms using blue or black ink only.

New Patient Health History Form (Welcome Form) - 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!

Download & Print Welcome Form

New Patient Consent Form-Required

Download & Print Form

Existing Patient Consent Form

Download & Print Form

Auto Accident Form

If you have been in an auto accident please inform us when scheduling your appointment.

Download & Print Form

Workers Compensation Form

If you are being seen for a work injury please inform us when scheduling your appointment.

Download & Print Form

Massage Intake Form

DOT Physicals

Please let us know that you're making a DOT physical appointment when you call and bring any required forms, including the DOT Medical Examination Report with "Driver Information" and "Health History" sections completed.

Download & Print Required DOT Physical Intake Form

Release of Records

Download & Print Release of Records Form

Authorization for Evaluation and/or Treatment of a Minor Child Unaccompanied by a Parent or Legal Guardian

Download & Print Consent Form

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