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     Chiropractor • Gaithersburg, Potomac, Urbana, Maryland
 
Patient Forms


Patient Forms

Thank you for choosing to download your forms online. At The King Chiropractic Institute, for over twenty two years, we have prided ourselves on respecting our patients' time. This is a simple step to that end, and we appreciate your efforts in aiding us in our mission.

Just a couple of quick notes. We realize much of the information is requested more than one time. It is not necessary to reenter information, such as name and home address, more than one time. If you have any questions while completing the forms, please do not hesitate to call. We welcome your questions!

Once the forms are completed, you can simply bring them with you for your initial visit, or, you can fax them to the office you will be visiting for your appointment. The fax numbers are on this letterhead for each office. We take your health privacy seriously, and that is the reason we do not have you transmit the return information over the web.

Once again, welcome. We want this to be the best health care experience you have ever had.

Yours in health,

The King Chiropractic Institute Team

Patient Master Form
40K PDF
X  
Confidential Patient Case History Form
565K PDF
X  
Sports, Spinal and Orthopaedic Disorders Form
45K PDF (each)
X  
Notice of Privacy Practices Form
140K PDF

You need Adobe Acrobat Reader to view and print the PDF files. It is available as a free download by clicking on the logo below:





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