Our popular Adult Intake Form is clean, professional and patient-friendly — making it the perfect first impression for your practice!
More importantly, by streamlining all the pertinent patient info you need to collect onto a single sheet of paper, they’ll make both patients and Docs equally happy by focusing only on the most important, well-organized information you need to lead the conversation about chiropractic and get more patients on a care plan that is right for them.
Each form includes the following sections:
- Confidential Patient Information
- Current Health Conditions
- Top Three Health Goals
- Chiropractic History
- Traumas: Physical Injury History
- Toxins: Chemical & Environmental Exposure
- Thoughts: Emotional Stresses & Challenges
- Acknowledgment & Consent
Key Features of all First Impressions Pro Forms:
- Collects only the most pertinent patient information, making them faster and easier for patients to complete.
- Organization and layout of information makes them more functional and efficient for chiropractors to find the info they need to recommend proper care.
- Clean and modern designs – customized with your contact info make them perfect for any practice!