WARNING

You are using an outdated browser. Please upgrade your browser to improve your experience.

Close [x]

Request Appointment

586-293-4440

Chiropractic Associates of Michigan offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Forms

Please contact your Chiropractic Associates of Michigan Front Desk Caregiver to determine which forms are suitable for your condition. Download the required forms and fill in as completely as possible. You can fax them directly to the clinic at 586-293-0840 in advance of your appointment, or bring them in with you on the day of your appointment. If you have any questions or difficulty when you are filling out the forms, simply call the clinic for clarification, or bring with you for your first visit and our staff will be happy to help you fill them out.

After downloading your forms, please continue to the Member Wellness Registration Form and Newsletter Sign-Up (following Comprehensive List of New Patient Forms)

NEW PATIENT FORMS:

NEW PATIENT PACKET     Download & Print Form

NEW PATIENT NUTRITION PACKET  Download & Print Form

26B - PATIENT TESTIMONIAL   Download & Print Form

27 - WORKSHOP EVALUATION   Download & Print Form

Notice of Privacy Practices Download & Print Form


Member Wellness Registration Form and Newsletter Sign-Up

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form­



Download the Free AdobeReader®

Go to top of page