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Request an Appointment



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

Download the Free AdobeReader®

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