New Patient Forms
Walk in ready. Skip the clipboard.
Fill out your intake paperwork at home and bring it signed to your first visit — so your time with us goes to getting you feeling better, not filling in forms.
Download
Pick the form for your visit below.
Fill & sign
On your computer or by hand, in ink.
Bring it in
Hand it over at the front desk and relax.
New: Fill It Out Online
Answer online, we fill in the form
Answer the new patient questions step by step and download the official form with your answers already filled in. Then just print, sign and bring it in.
Your answers never leave your device.
Interactive Forms
Fill it in on your computer
We offer an Interactive New Patient Form. Please complete the highlighted regions with your computer, then print out the form. Some areas are not fillable, so please review the forms after you have printed them. Then sign the form and bring it with you to your first visit.
Quick Download
Print and fill in by hand
For slower internet connections, the Quick Download New Patient Form link will provide you with the patient intake form. Please print out the form, fill it in with your information, sign the form, and bring it with you to your first visit.
Massage & Laser
Massage and laser patient paperwork
Print out the intake form for your service, fill it in with your information, sign it and bring it with you to your first visit.
Hyperbaric
Thank you for selecting our hyperbaric team!
We will strive to provide you with the best possible service. To help us meet all of your needs, please fill out this form completely in ink.
Ready to move forward?
Tell us what is getting in the way. We will help you understand the next best step.
New patient? Download your forms →James Bogash, DC · LifeCare Chiropractic
1830 S Alma School Rd, Ste 135, Mesa, AZ 85210