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Follow Us

Chapel Hill Family Chiropractic offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form


Functional Questionnaires

Please fill out one or both of the following questionnaires online, the results will be submitted to Chapel Hill Family Chiropractic for our review.  We will reach out to you via email, or if you are scheduled we will follow-up with you about your results during your visit.

Neck Pain Questionnaire

Go to the questionnaire


Back Pain Questionnaire

Go to the questionnaire