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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

To apply for a Functional Care initial appointment, please call us at 816-741-4711 to get started.

Additional Paperwork For PANS/PANDAS Patients

pdf iconPANS Basic History

pdf iconPANS Intake History

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Fountain of Life Family Chiropractic

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