We have added the necessary forms for you to download, fill out and bring to your first appointment. If you decide not to fill these out before you
arrive, please arrive between 15-20 minutes early. In addition to these forms, please bring picture ID and your insurance card to the first appointment.
All patients, please read: Greater Rochester Chiropractic's Notice of Privacy Practices
All patients, please complete:
Acknowledgement of Receipt of Notice of Privacy Practices
Office Guidelines & Fee Policy
Adult Patients
This lets us know the history and current state of your condition and health.
New Patient FormsAutomobile Accident (No-Fault)
If the purpose of your visit is due to injuries sustained in a motor vehicle accident you must fill out these forms.
Pediatric Patient History
Pediatric New Patient Forms: Ages 0–5
Pediatric New Patient Forms: Ages 6–12
Pregnant Patients
If you are currently pregnant please print and fill out these forms:
Prenatal New Patient Forms
Workers' Compensation
If you have a workers' compensation claim please print and fill out these forms:
Workers' Compensation New Patient Forms