Online Forms

Lighthouse Family Chiropractic offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your completed form(s) to (614) 876-0996 or bring them with you to your appointment.

New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

NOTE: ONLINE SUBMISSION WILL ONLY WORK FROM A COMPUTER OR IPAD;

PLEASE DON'T USE A PHONE TO COMPLETE.

ONLINE PATIENT INTAKE FORM




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