Skip to content

Online Paperwork

We offer our paperwork online so you can complete it in the convenience of your own home. Call us or Click here to email us your questions!


New Patient – Chiropractic Registration and Intake Forms

These documents let us know what’s happened, but perhaps more important, where do you want to take your health?

pdf iconDownload & Print Form


New Therapeutic Massage Client Forms

pdf iconDownload & Print Form


New Patient – Children

pdf iconNewborn – 3 Years

pdf icon4 – 8 Years

pdf icon9 – 13 Years


Dr. Alex New Patient Functional Care Paperwork

pdf iconDr. Alex Adult History

pdf iconAdult Metabolic Questionnaire

pdf iconAdult Neurotransmitter Questionnaire

pdf iconDr. Alex Adult Cognitive Checklist

pdf iconDr. Alex Child Checklist

pdf iconDr. Alex Child History Form

pdf iconDr. Alex Child Questionnaire

pdf iconDr. Alex Child Screens Questionnaire


Free AdobeReader®

Get adobe reader

Each form is a PDF document file. If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.


Fountain of Life Family Chiropractic

Contact Us | (816) 741-4711
Chiropractic Website by Perfect Patients.