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Online Forms

White Sands Chiropractic Clinic offers our patient form(s) 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 form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Form - 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!

Download & Print Form


Authorization For Chiropractic Treatment - Required

Download & Print Form


Confidential Health Profile Intake Page 1- Required

Download & Print Form


Confidential Health Profile Page 2 - Required

Download & Print Form


Missed Res and Appt Reminder Set Up - Required

Download & Print Form


Notice To Patients Financial - Required

Download & Print Form


STD HIV Disclosure - Required

Download & Print Form


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Our Locations

Office Hours

Monday:

9:00 AM-12:00 pm

2:00 PM-6:00 pm

Tuesday:

9:00 AM-12:00 pm

2:00 PM-6:00 pm

Wednesday:

9:00 AM-12:00 pm

2:00 PM-6:00 pm

Thursday:

Closed

Friday:

9:00 AM-12:00 pm

2:00 PM-6:00 pm

Saturday:

Closed

Sunday:

Closed