New Patient Checklist:

1. Call to set up appointment (585) 672-5301
2. Print and fill out the "New Patient Intake Form"
3. Print and fill out the Neck or Back Disability Questionnaire, if applicable
4. Sign up on the website as a member for special access to online materials
5. Collect any relevant imaging, lab results or health documents for the doctor's review
6. Get directions to the office from the website
7. Bring these with you to your first appointment:

• Tank top or T-shirt for upper body complaints
• Loose fitting shorts for back and lower body complaints
• Copy of updated Insurance card, if applicable
• Completed Intake Forms

New Patient Intake Form - Required

We want to know your health story and the current state of your health. Please fill this out thoroughly so we know what questions, concerns, goals you have that we can help you with.

Neck Disability Questionnaire

Print Form

Back Disability Questionnaire

Print Form

Member Wellness Registration Form 

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 office. You can print it out and bring it in to our office 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!

Fullest Life Chiropractic, PC offers our patient form(s) online so they can be completed it 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.