Long Island Chiropractic & Physical Therapy offers our patient form(s) online so they can be completed 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.
Patient Health History 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!
Patient Information and Authorization Form
Neck Index
This questionnaire will give the doctor information about how your neck condition affects your every day life.
Back Index
This questionnaire will give the doctor information about how your back condition affects your every day life.
