New Patient Forms

About Your Health

The human body is designed to be healthy. Throughout your life, events occur that damage your overall health potential. This case history will help us uncover the layers of damage, especially to your nervous system, which results in poor health. We do this by viewing your health history from birth to now, so that  we can evaluate your health over the course of your entire life. Following your exam, your chiropractor will outline a course of care to begin to correct these layers of damage and recover your true health potential.

To make your first visit in the office as easy as possible we ask that you please fill out both forms to the best of your ability. You are able to fill out both forms online* or you can print and fill out by hand. Bring both forms with you to your first appointment, or email completed versions back to us at We can also email you both forms, if you have an questions just call us at 734-489-1621 and we will be glad to help!




*Having trouble filling them out online? Click here to download free Adobe Reader DC