Online Forms


Quality Chiropractic Center offers 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 it out & fill in the required information with detail.
  • Bring in your printed and completed forms with you to your appointment.

New Patient Health History Form - Required (The 1st of 4 forms to download)

This lets us know the history and current state of your health & what questions, concerns, goals, regarding wellness that we can help you with. Please be as detailed as you can, as this will help the exam process be more efficient.  If you have any questions, the doctor can help answer them when you see him.

Download & Print Form

Brain Region Form - (The 2nd of 4 forms to download)

We  have a Brain Region Form that will assist the doctor on a better overview of your health to get to the root of different problems.  He is a Board Certified Chiropractic Neurologist, so he utilizes these extra forms to give him a better picture of how he can help you.

Download & Print Form 

Neurotransmitter Assessment Form - (The 3rd of 4 forms to download)

We also have a special questionnaire form that too will help assist the doctor in getting you to your optimal health.

Download & Print Form


Metabolic Forms - (The 4th of 4 forms to download)

Download & Print Form


HIPAA - Notice of Privacy - (This is optional for you to download & print, as it's for you to keep)

Download & Print Form 


AUTHORIZATION FOR RELEASE OF HEALTH INFORMATION - (This is optional & not part of new patient forms)

DOWNLOAD & PRINT IF YOU NEED A MEDICAL RELEASE FORM


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CONTACT US TODAY

We look forward to hearing from you

Office Hours

Our Regular Schedule

Monday:

10:15 am-1:00 pm

2:00 pm-6:00 pm

Tuesday:

By Appointment

or Emergency Basis

Wednesday:

10:15 am-1:00 pm

2:00 pm-6:00 pm

Thursday:

By Appointment

or Emergency Basis

Friday:

10:15 am-1:00 pm

2:00 pm-6:00 pm

Saturday:

By Appointment

or Emergency Basis

Sunday:

By Appointment

or Emergency Basis

Location

Find us on the map

Testimonial

  • "Amazing. Unlike any chiropractor I've ever been to. Game changer."
    Jenny F. / Moscow, ID

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