Infants and Toddlers. Ages: Birth to 5 years old.
Pediatric Infant and Toddler Paperwork
School Aged Children. Ages 6- 11 years old.
Pediatric School Aged Children Paperwork
Adults, Non-Pregnant. Ages 12 to 100+
Adult Paperwork
Pregnancy
Pregnancy Paperwork
Extensive History Form are for Fertility and Fatigue
PLEASE PRINT and Fill Out! Complete History Form
If using Insurance, Please fill out this Form
Insurance Form
HIPPA– Please Read!
Hippa
What our clients are saying...
"Dr. Brenda has worked as my chiro for a while now and I could not be happier. I love being able to go in and tell her exactly what’s going on and she sympathizes and knows exactly what to do. I also get the full experience with her by getting diet and exercise suggestions which makes my appointment feel extremely well rounded. I can bring my son in and not feel like he doesn't belong. It is extremely kid friendly and she even gets him in on helping her out which makes him so happy."
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