My Chiro On The Go offers our patient form(s) online so they can complete them in the convenience of their own home or office.
- Foms A-C can be completed online through the links below, all of them should take 10-15 minutes to complete. If you are being treated for an auto accident or personal injury please also complete forms D and E, these should also take 10-15 minutes to complete.
- If you wish to print the paperwork instead please print forms F-K and complete prior to the Doctors arrival.
- If you do not already have AdobeReader® installed on your computer, click here to download.
- Fax us your printed and completed form(s) to (470)355-0136 or present them at your appointment.
Everyone Patient MUST fill out forms A-C Before receiving treatment
B. Complaint Form online (Fill out once for each area of complaint, If you do not have any complaints you may skip this form)
If you have been an AUTO ACCIDENT OR HAD A SLIP AND FALL please also fill out:
If you cannot fill out these forms online please print and complete the following prior to your appointment:
If you have been in an AUTO ACCIDENT OR HAD A SLIP AND FALL also print and fill out the following: