CONGRATULATIONS on taking the next step toward improved health and wellness!
The following forms are required to be completed prior to your first visit.
There will be additional forms to fill out and sign upon arriving for your initial appointment.
PLEASE: Do Not Date (Your paperwork must be dated for the day of your appointment)!!!
If something is “not applicable” please put “N/A”.
Each check box needs to be checked off individually.
Paperwork must be filled out entirely! Each question must be answered.
We would greatly appreciate it if you would complete and return all forms as soon as possible.
The best way to return them is to email them to:
Please call us with any questions!
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Disclaimer: The information provided on this website, by Lake Nona Family Chiropractic, is for general use only. Any statement or recommendation on this website does not take the place of medical advice nor is meant to replace the guidance of your licensed healthcare practitioner. These statements have not been evaluated by the Food and Drug Administration. Lake Nona Family Chiropractic information is and products are not intended to diagnose, cure, treat, or prevent any disease or provide medical advice. Decisions to use supplements to support your specific needs should be considered in partnership with your licensed healthcare practitioner.