Fair Oaks Chiropractic & Wellness Center​ 

New Patients

Save some time at our office and fill out your new patient forms at home! Please download ALL of the appropriate files and bring them with you to your first appointment. Or, if you prefer, use our pre-printed forms when you arrive at the office. 

*Walk-In Patients pay with cash, checks, credit and some insurance.

**Personal Injury Patients are reimbursed with insurance coverage.

Call us to schedule an appointment at (916) 965-4125.

Walk-In Patient's Forms*

1. Patient Information Page
   
2. Patient Health History Form
   
3. Informed Consent to Chiropractic Care
   
4. HIPPA Notice, Page 1
   
5. HIPPA Notice, Page 2
   
6. HIPPA Notice Receipt
   

Personal Injury Patient's Forms**

1. Patient Information Page
   
2. Consent for Care Form
   
3. Patient Health History Form
   
4. Accident Information, Page 1
   
5. Accident Information, Page 2
   
6. HIPPA Notice, Page 1
   
7. HIPPA Notice, Page 2
   
8. HIPPA Notice Receipt
   
9. Notice of Doctor's Lien
   
10. Authorization and Assignment