Online Forms

ONLINE FORMS

BackFit Health + Spine understands how valuable your time is; as a result, we offer our patient form(s) online so they can be completed in the convenience of your own home or office. For all new patients who are inquiring about care, click here for internet special.

  • Adobe Reader is required to view online forms. If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print and fill in the required information.
  • Fax us your printed and completed form(s) or bring them to your appointment.

Patient Application for Treatment Form – New Patient Health History Form – Required for all new patients. This tells us the history and current state of your health. The information completed on these forms will help the Doctor properly assess, diagnose and treat your current condition.

Download & Print


Auto Injury Intake Form – required if your visit follows an auto injury.

This form is required if you were in a motor vehicle accident. Please complete the above Patient History Form as well.

Download & Print Form 1

Download & Print Form 2


Massage Intake Forms

Download & Print Form – Massage Patient Application

Download & Print Form – Massage Scheduling or Cancelling

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Aplicación Paciente para Forma de Tratamiento – Nueva Forma de Historia de Salud Paciente – Requerido para todos los nuevos pacientes. Este nos deja saber la historia y el estado corriente de su salud. La información completada en estas formas asistirá al Doctor a tasar correctamente, diagnosticar y tratar su condición corriente.

Descargar E Imprimir


La Forma de Consumo de Herida Automática – Requerido si su visita a nuestra oficina fuera a consecuencia de una herida automática.

Se requiere este formulario si usted ha estado en un accidente de auto. por favor complete nueva forma paciente anterior también.

Descargar E Imprimir Forma Uno

Descargar E Imprimir Forma Dos


Formas De Massage

Download & Print Form – Aplicacion Paciente Masaje

Download & Print Form – Cancelacion De Masaje

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