New Patient Intake Forms

We offer our paperwork on line so you can complete it in the convenience of your own home. Here are the essential forms we use and why we need them.


Intake Forms

This initial very important form lets us know your history, complaints, lifestyle factors, and your health goals.
 Download & Print Form

If you are completing these forms for a minor child, please include this consent form.
 Download & Print Form

Please read and sign this form if you are a Medicare patient.
 Download & Print Form


Privacy Policy

We provide our Office Policy and Privacy Policy for your review.
 Download & Print Office Policy

 Download & Print Privacy Policy


Free AdobeReader®

Each form is a PDF document file.  If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.

Dr. Michael  Asks some important questions of interest to Toledo residents - Chiropractor Toledo Dr. Michael Asks...

What happens if you stop chiropractic care when you feel better?
Many Toledo folks recognize that this predisposes you to a relapse. Chiropractors know that muscles and ligaments supporting the spine don't fully heal until after symptoms subside.
Can a chiropractor heal?
There's never been a case in which a doctor (chiropractor or otherwise) has formed scar tissue, mended a broken bone or cured a headache. Only you can do that. Turns out you're the doctor! All I do is help remove interferences to your body's healing ability. Ready to get started? Call our office today.