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Online Forms

Encinitas Chiropractic 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 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.

New 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!

Download & Print Form



Prenatal Health History

"For the soon-to-be moms, here is our health history form for you. Our goal is to tailor your care as much as we can to ensure a healthy baby, and a healthy mommy!"

Download & Print Form



Neonatal Infant History

"This is for the newborn or infant in your life. Your child's history and health is important to us. Let us help you and your child in the best way possible!"

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Toddler History

"Your young toddler and child deserves the same attention you do. This will help us learn their health history, such as eating behaviors, birth delivery, and, of course, their current health. A healthy child is a happy child!"

Download & Print Form


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