Our team of chiropractors are ready to see you today!  Simply select your doctor's name below to navigate to their forms required for your first visit to the practice. To save time, you are welcome to  fill out forms and bring them with you to your appointment. 

Some of the offices provide online New Patient intake forms.  Please note!! Filling out these forms does not confirm you made an appointment.  

We know you have a choice when selecting a chiropractor, so THANK YOU for choosing us and trusting Chiropractic Partners with your care!

Dr. Houfek
Raleigh, North Hills


Dr. Case-Luca

Dr. Ferez

Dr. Clements
Raleigh, NorthWest

Dr. Krasnov and Allard
Durham Ch.Hill Blvd

Dr. Presas
Durham, Southpoint

Dr. Ransone&Keadle
Raleigh, North

Dr. Redd
Wake Forest

Dr. Schmid
Raleigh, North

Dr. J. Smith
Raleigh, Capital Blvd.

Dr. S. Smith
Raleigh, Capital Blvd

Dr. Wallace

Dr. Case-Luca

Paperwork available in the office at time of appt.

Dr. Ferez

Initial Consultation Form

Personal Health History Form

Neck Index Form

Back Index Form

Dr. Houfek

Forms available in office at time of appointment

Dr. Krasnov

NP - Back

NP - Neck

PI - Paperwork

Dr. Presas

New Patient Forms

Personal Injury Form

Work Injury Form

Dr. Ransone & Dr. Keadle

New Patient Intake Form

Assignment of Benefits Form

MD Communication Form

Disclosure Authorization

Informed Consent Form

Insurance Assignment Policy

Oswestry Disability Form

Review of Systems Form

Headache Index Form

Neck Pain Index Form

Personal Injury Information Form

Personal Injury Questionnaire Form

Update Health Information 2020

Dr. Redd

New Patient Health History Form

Patient Information Update Form

Auto Accident Injury Form

Personal Injury Form

Drs Lancaster and Sullivan

New Patient Form

Dr. John Smith

New Patient Forms

Dr. Sean Smith

New Patient Forms

Dr. Schmid

New Patient Health History

Consent to Treat Form

HIPAA Policy Form

Insurance Assignment Form

MD Communication Form

Direct Payment Form

Auto Accident Questionnaire Form

Lower Back Questionnaire Form

Neck Disability Questionnaire Form

Personal Injury Information Form

Dr. Wallace

Submit Form Online

Dr. Graham Clements

Forms available in office at time of appointment


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