New Chiropractic Patient Paperwork

We are very excited for the opportunity to serve you. In an effort to make this process easier and more convenient for you, we have our new patient paperwork online and available for you to download. If you prefer to complete this paperwork in our office, we are more than happy to provide it when you arrive.

Please download and print the applicable form below. Please bring the completed form to your appointment. Thank you.

New Patient Forms

Click to Download: Confidential Patient Information Form

Click to Download: New Patient History Form

Auto Accident Form

Click to Download: Accident Description Form

Clinic Policies 

Click to Download: Clinic Policies Form



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City Chiropractic Location

Address

806 SW Broadway #350,
Portland, OR 97205

Office Hours

Monday  

9:00 am - 6:00 pm

Tuesday  

Closed

Wednesday  

9:00 am - 6:00 pm

Thursday  

2:00 pm - 6:00 pm

Friday  

9:00 am - 6:00 pm

Saturday  

Closed

Sunday  

Closed

Please sign up using the form below or call us at (503) 224-9513 to make an appointment

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Please do not submit any Protected Health Information (PHI).