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New Patient Forms
at Smasal Family Chiropractic

Man filling out paperwork
Please complete and submit all of the forms listed below.

Patient Intake Forms

Adult Intake Forms

Pregnancy Forms

Pediatric Forms

UHC Authorization Forms

UHC AUTH Patient Summary Form

Neck Index

Back Index

DASH Questionnaire

Lower Extremity Functional Scale


New Patient Forms at Smasal Family Chiropractic | (414) 774-6757