Patient Intake Forms

Welcome to Lifeforce Chiropractic Inc. in Pittsburgh! In this section you will find out how we can help you as a new patient. You can download Patient Intake Forms, take a tour of our office, use our My First Visit Interactive Tour, and learn more about your responsibilities as our patient. Please select a topic below that you would like to learn more about.

TO BE COMPLETED ONLINE: CLICK ON THE URL BELOW TO COMPLETE THE ONLINE PATIENT INTAKE ASSESSMENT FORM. https://www.mychirotouch.com/patientintake/?clientid=LCI0003 PRINTABLE PEDIATRIC INTAKE FORMS: New Patient Newborn 2 Months New_Patient_2_Months_to_2_Years.pdf

You will need Adobe Reader to view and print this document. If you do not have Adode Reader click the Icon below to download a free copy.     Additional Forms:   Neck Pain Questionaire Roland Morris Questionnaire Owsestry Disability Index  Adrenal Fatigue Check  Iodine Patch Test Thyroid Temperature Test Thyroid Questionaire Hypothroid Check Basel Temperature Test Gallbladder and Liver Flush Symptom Survey Form Diet Plan