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Standridge Chiropractic offers our patient form(s) online so they can be completed it 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 form(s) or bring it with you to your appointment.

New Adult 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

New Pediatric Patient Health History Form - Required

This lets us know the history and current state of your child's health. What questions, concerns, goals, regarding wellness can we help them with? Let us know!

Download & Print Form


Auto Accident Form

This form allows us to get everything we need concerning your auto accident in order to communicate with the adjusters and attorneys. Filling this out completely can make all the difference to your case.

Download & Print Form

Physical Form

We offer affordable high school physicals and standard physicals at only $20.00. This is the typical form you should bring in with you.

Download & Print Form

United ACN Form

Certain United Healthcare plans are regulated by ACN. In order to be pre-approved for chiropractic care, these forms will have to be completed for us to submit to them.

Download & Print Form


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form


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