Are you a new patient at Back-in-Action? We’d be delighted if before your visit you could download these forms and fill in the details about your problem (Chiropractic New Patient Registration – Adult) and your medical history (Chiropractic New Patient Medical History Form – Adult).

Before we can start to help you get better, it is important that you are aware of any possible risk or side effects that might be associated with the treatments we use. Please read through our Informed Consent Information. We ask for you to sign to say you have read this document in your New Patient Registration Questionnaire.

If you’ve had a road traffic accident please can you also fill out our Accident Report Questionnaire.

Most of these forms are a bit of a marathon but it’s worth the effort because they provide us with a lot of useful information which helps us to help you get better.

We have specific forms for younger children – Chiropractic New Patient Registration – Children.

Please return these forms to us prior to your consultation if possible or bring the forms you need with you when you come in for your New Patient Consultation. They are a bit of a marathon so we recommend filling them in gradually. Probably if you were pushed they might take 20-30 minutes to fill them in properly, longer if a more leisurely pace is needed.

If you want to know more about what to expect on your 1st Chiropractoc New Patient Consultation visit, please follow the link.

Please click on the form to download the document…