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Request an Appointment

719-475-9103

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Right Health Clinic offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary forms (#1 through #5), print them out and fill in the required information.  If you have insurance, also complete the last form listed below.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.  Our fax number is (719) 475-2225

1. New Patient Health History Form

Download & Print Form


2. New Patient Registration

Download & Print Form


3. Case History

Download & Print Form


4. Informed Consent Form

Download & Print Form


5. Acknowledgment of Receipt of Privacy Practices

Download & Print Form


Insurance Information Form

Download & Print Form


Motor Vehicle Accident Intake Form

Download & Print Form


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