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, please fill out forms and bring them with you to your appointment. 

Thank you for choosing Chiropractic Partners! You can trust us with your chiropractic care! 

Dr. Houfek
Raleigh, North Hills

Dr.Lancaster&Sullivan
Cary 

Dr. Case-Luca
Garner

Dr. Ferez
Clayton 

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
Fuquay-Varina



Dr. Case-Luca

Submit Form Online


Dr. Ferez

Initial Consultation Form

Personal Health History Form

Neck Index Form

Back Index Form


Dr. Houfek

Submit form online


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

(adding forms soon)

Locations

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