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760-753-3488
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Exclusive Offer

call or email for a Free Consultation to see if we are a good fit 

Encinitas Chiropractic 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.
  • 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


Prenatal Health History

"For the soon-to-be moms, here is our health history form for you. Our goal is to tailor your care as much as we can to ensure a healthy baby, and a healthy mommy!"

Download & Print Form


Neonatal Infant History

"This is for the newborn or infant in your life. Your child's history and health is important to us. Let us help you and your child in the best way possible!"

Download & Print Form


Toddler History

"Your young toddler and child deserves the same attention you do. This will help us learn their health history, such as eating behaviors, birth delivery, and, of course, their current health. A healthy child is a happy child!"

Download & Print 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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Featured Services

Services
We strive to provide complete care for our patients. Learn more about all the services we provide.
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Online Forms
Our patient forms are available online so they can be completed in the convenience of your own home or office.