Intake Forms

Long Chiropractic Center offers our patient forms online so they can be completed in the convenience of your own home or office.

• Download the forms below and fill in the required information.
• Please bring forms with you to your appointment.

Patient Intake Form (Adult)

Download & Print Form

Patient Intake Form (Child) 

Download & Print Form

Patient/Doctor Agreement

Download & Print Form

Text/Email Reminder Form

Download and Print Form