Patient Forms

New Patient Forms

(clicking link will open an electronic intake form)

https://www.mychirotouch.com/patientintake/?clientid=RCL0009

**** MUST BE PERFORMED ON A DESKTOP OR LAPTOP

 

PLEASE BE SURE TO SIGN THE FORM ELECTRONICALLY BEFORE SUBMITTING

 

 

Outcome Assessment Forms

Roland-Morris Low Back Pain

Oswestry Low Back Pain Index

Neck Disability Index

 

 

 

Raymond Chiropractic Spine Stretches

Lumbar Stretches

Cervical Stretches

All Raymond Chiropractic Forms require Adobe Reader which can be downloaded here.