Below please find the necessary forms 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 earlier than your appointment time. In addition to these forms, please bring a photo ID and your insurance card to the first appointment.
All patients, please read: Greater Rochester Chiropractic's Notice of Privacy Practices
Age 18 and over patientsNew Patient Forms
Automobile Accident (No-Fault)
If you are here due to injuries sustained in a motor vehicle accident, please print and complete these forms.
Pediatric New Patient Forms: Ages 0–5
Pediatric New Patient Forms: Ages 6–12
If you are currently pregnant please print and fill out these forms.Prenatal New Patient Forms
If you have an open workers' compensation claim or were recently injured at work, please print and fill out these forms.Workers' Compensation New Patient Forms