Patient Forms

In order for us to better understand your present condition and save you time in the clinic, please download, print and fill out the appropriate New Patient Intake Forms before you arrive.

Bring all forms in with you on your first visit.  If you have prior lab results, x-rays or other health records you would like Dr. Aungst to review, bring copies of these as well.  All personal health information is held in the strictest confidence.

See you soon!

For Chiropractic, Nutrition and Allergy Patients:

• New Patient Intake Form
• Medicine and Supplement Usage Form
• Nutritional Questionnaire

Nutritional patients should bring the vitamins they are currently taking to their first appointment.

Allergy patients should bring a sample of any suspected allergens (i.e. dog hair, foods, shampoos, cosmetics, etc.)

For Auto Accident Patients:

• Confidential Patient Information
• Auto Accident Questionnaire
• Health History
• Pain Chart
• Pain Rating Scale
• Activities of Daily Living

Please download and read the Initial Instructions for Auto Accident Patients

Also provide the names, addresses and phone numbers of any providers already seen for this injury. Referrals are not required.

For Workers Comp Patients:

• Confidential Patient Information
• Health History
• Pain Chart
• Pain Rating Scale
• Activities of Daily Living

Also bring a copy of the Form 801 you filled out for your employer, the name and address of your employer's work comp insurance carrier, the WC claim number if one has been issued, and the names, addresses and phone numbers of any providers already seen for this injury. Referrals are not required.