Paperwork – Health History Forms

Want to save time in our office? Please download and complete the appropriate forms for new patients in the comfort of your own home, and bring it with you to your appointment. If you have any questions at any time, please don’t hesitate to contact our office at (970) 460-0551.

Get Adobe Acrobat Reader.

Adult Paperwork (18 years of age and over)

Consent to use PHI

Health History Intake

Informed Consent

Minor Paperwork (4-17 years of age)

Consent to use PHI

Health History (4-17)

Informed Consent-Minor

Minor Paperwork (Infant-3 years of age)

Consent to use PHI

Health History (Infant-3 Years of Age)

Informed Consent-Minor

Any more questions? Feel free to write us an email!

Days
Monday
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Wednesday
Thursday
Friday

Hours
7:00 AM – 6:00 PM
7:00 AM – 6:00 PM
7:00 AM – 6:00 PM
7:00 AM – 6:00 PM
7:00 AM – 6:00 PM

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Norco Chiropractic – Windsor, CO | Chiropractors & Chiropractic Treatment | 1550 Main Street, Unit 112, Windsor, CO 80550
Phone: (970) 460-0551 | Fax: (970) 460-0182 | Email: drwes@norcochiropractic.com

Located in Windsor, Colorado. This practice is required, by law, to maintain the privacy and confidentiality of your protected health information and to provide our patients with notice of our legal duties and privacy practices with respect to your protected health information.

DISCLAIMER

The information contained in this website is for general information purposes only. The information is provided by Norco Chiropractic and while we endeavour to keep the information up to date and correct, we make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, suitability or availability with respect to the website or the information, products, services, or related graphics contained on the website for any purpose. Any reliance you place on such information is therefore strictly at your own risk.

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