Phillips Family Chiropractic offers our patient forms 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 forms at 724-287-0496 or simply bring them with you to your appointment.
If you are a new patient to our office or if it has been more than 3 years since your last office visit, please fill out Parts 1 and 2 of the New Patient Intake Form.
New Patient Intake Form (Part 1 of 2)
New Patient Intake Form (Part 2 of 2)
Massage Therapy New Patient Intake Form
Authorization to Release Records
UPMC Authorization to Release Records
Auto Accident Form