Laurel Street Chiropractic & Rehab offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our clinic. Please take a few moments to fill them out and then you can either print them to bring with you, or fax them to us prior to your appointment. Our fax # is 907-258-6610.
- 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 Patient Intake Form - Required
This gives us all the necessary information required to set up your account. If you have insurance coverage, please be sure to fill in your subscriber information where indicated.
New Patient Health History Form - Required
This form tells us all about your current condition. Please be as descriptive as possible so that we are able to determine what the best course of treatment will be. If you have any questions, please ask!