New Patient Forms

Please print and complete the following forms before you arrive for your first appointment.  If for some reason you cannot print the forms or forget to bring them. Please arrive 1/2 hour early for your appointment to fill the forms out in the office.  I want all of your appointment time to be dedicated to examination, diagnosis and treatment please.

Thank you…I look forward to seeing you.

Nicolai Lennox, D.C.

Informed Consent (PDF) 

New Patient Intake Form (PDF)

Notice of Privacy Practices (PDF)

New Patient Information (PDF)

Patient Symptom Survey (PDF)

You will need Adobe Reader installed on your computer to open and print these forms. If it’s not already installed  on your computer, you can get free by visiting http://www.Adobe.com

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  1. Raylene
    4 years ago

    Nice job Nicolai and Robert!