Patient Forms

We offer 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 forms, print them out and fill in the required information.
• Fax us your printed and completed forms or bring them with you to your appointment.

Here are some of the various forms that we may need you to fill out before seeing Dr. Harris.  Please contact our office before printing any of these so that we can make sure you are using the correct forms.

New Patient Forms
Auto Accident
Cash or Health Insurance
first visit or first visit in over three years

Patient Update Form
first visit in over three months or if asked to fill out an update

Insurance Health Questionare
some insurance groups require this form

Consent To Treat Minor Child
required for Dr. Harris to treat a minor

Privacy Practices
Harris Chiropractic Clinic's privacy practices