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Spinal Solutions Chiropractic and Wellness Center offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • ​For new chiropractic patients, please read the pre-scan checklist below and begin thoroughly filling out the new patient intake form.  Please be sure to fill out all sections, leaving no questions blank, insert n/a if necessary.  Any incomplete or missing information will need to be addressed in the office.  The form will need to be electronically signed and submitted online at least 2 days prior to your first appointment.
  • For new massage only clients, download the two necessary form(s), print it out and fill in the required information.  Fax us your printed and completed form(s) to (586) 992-6962 or bring it with you to your appointment.

New Chiropractic Patient Health History Forms - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Here at Spinal Solutions, we use state of the art examination equipment, certified by the Space Foundation, to examine your nervous system and how stress may be affecting your health.  Many things can affect your nervous system function, so please read and avoid the following items on the day of your scan and any followup scans:

Pre-Scan Checklist:

  • Drinking coffee or tea can excite the nervous system- avoid drinking more than what's normal for you on the average day
  • Cola drinks contain caffeine and chemicals that can affect the nervous system- avoid drinking more than what's normal for you on the average day
  • Common, over-the-counter drugs can impact the nervous system- avoid taking OTC meds until after your scans, unless absolutely necessary
  • Many prescription drugs and muscle relaxers affect the nervous system- avoid taking prescription medication until after your scan, unless absolutely necessary
  • Excessive exposure to the sun affects the accuracy of your scan- please avoid
  • Bath salts, oils or sunscreen on your skin can influence instrument sensitivity- please avoid
  • Vigorous physical activity can exaggerate your scan results- please avoid prior 2-3 hours before scan
  • Stress, depression, anxiety or emotional upsets can affect nervous system tension- please reschedule if you cannot avoid increased stress, compared to a typical day, on the day of your scheduled scan

New Patient Intake Form


New Massage Client Forms

On your first visit the massage therapist will review your paperwork with you and discuss your expectations and health goals.  It is extremely important that the forms are filled out thoroughly and all health history is disclosed as there are contraindications and cautions for massage.

Intake Form


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our chiropractic office. You can print the form out and bring it in to our office during your next visit with our chiropractor, or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form



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