A Better Life 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 printed and completed form(s) or bring it with you to your appointment.
Please print and complete the new patient forms below. Once complete, you may fax all pages to: (239) 263-8842. For your identity protection do not submit new patient forms via email.
New Patient Without Insurance:
New Patients With Insurance:
New Patient With Auto Accident Insurance:
Records Release Forms:
(SE HABLA ESPANOL)