Forms

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 Forms


Automobile 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.

No-Fault New Patient 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

Locations

Close to 590, Monroe Avenue, 12 corners

Hours

Brighton Hours

Monday:

8:00 am-6:30 pm

Tuesday:

7:00 am-5:00 pm

Wednesday:

8:00 am-6:30 pm

Thursday:

8:00 am-5:00 pm

Friday:

7:00 am-5:00 pm

Saturday:

Temporarily closed

Sunday:

Closed

Webster Hours

Monday:

Closed

Tuesday:

Temporarily Closed

Wednesday:

Closed

Thursday:

Closed

Friday:

Temporarily Closed

Saturday:

Closed

Sunday:

Closed