Health Update Forms

These are various forms you can use to update us on your health history. Please use a form filling software such as Adobe Acrobat or print off what you need, complete them as best as you are able and return them to the clinic (via email or post).

During COVID 19 we need to talk through any changes with your history over the phone before we can see you face to face. We can do this once we have received your forms and had chance to go through them.


We will need your consent before treatment. Many of the forms below refer to you understanding the possible risks and side effects of Chiropractic. These are outlined in our ‘Informed Consent Document. Please read the following:

Informed Consent Information







During the COVID outbreak please read and sign this COVID Consent Form to and return it to the clinic (by email or post) or bring it in with you.

Consent For Treatment During COVID








If you have been to the clinic within the last year and have a New Problem please update us with your medical history.

New Problem History Form







If you’ve been to the clinic before but it’s been awhile (over 1 year) please fill out our Returning Patient Consultation form to update us with your current health issues, remind us of your past problems and make sure we have your personal details correct.

Return Patient Consultation Form







If we’ve asked you to book in for a Reassessment Visit please fill out this questionnaire:

Reassessment Form







If you’re a regular client and it’s been your birthday recently, we will have invited you for an Annual Reviewplease fill out the questionnaire below:

Annual Review








From the Preston Chiropractor Team
Getting You Back in Action & Enjoying Your Life Again
Serving the people of Preston and surrounding areas including Southport and Lytham St Annes