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Online Forms

We offer our paperwork on line so you can complete it in the convenience of your own home. Contact us if you have any questions.

Adult Health History

This let’s us know what’s happened, but perhaps more important, where do you want to take your health?

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Birth-17 years Health History

Same as above, but for kids!

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United Health Care and AETNA – ACN forms

In addition to the forms above, if you have United Health Care or Aetna insurance please print off the forms that apply and fill them out before you come to the office. Note: you must scroll to the bottom of the “Summary of Symptoms” form to fill out the necessary portion.

Summary of Symptoms

Back Index

Neck Index

The STarT Back Musculoskeletal Screening Tool

High Point Chiropractic | (336) 882-2434