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 AdobeReaderŽ 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. If you have any questions, 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
Harris Chiropractic Clinic's privacy practices
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. 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!
Click Here to register online!
Download the Free AdobeReaderŽ
3D Spine Simulator
Launch 3D Spine Simulator