New Patient Paperwork

Synergy Chiropractic offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • All forms are PDF files. You will need AdobeReader® to view them.
  • If you do not already have AdobeReader® installed on your computer,
    Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Bring the necessary form(s) to your appointment.
  • New Chiropractic Patient Paperwork

    Click to Download

  • Pregnancy Intake Form

    Click to Download

  • Neurofeedback Intake Form

    Click to Download

  • Adult Self Report Scale Symptom Checklist

    Click to Download

  • Child Self Report Scale Symptom Checklist

    Click to Download

  • Terms of Acceptance

    Click to Download

  • RemedyTesting - Intial Intake

    Click to Download

  • RemedyTesting - Follow up

    Click to Download

  • RemedyTesting - Pet Intake

    Click to Download

  • RemedyTesting - Sample Report

    Click to Download

  • Limits of Confidentiality/Cancellation Policy

    Click to Download

  • Authorization to Disclose Information Form

    Click to Download

OFFICE HOURS


Monday
9:00am - 6:00pm


Tuesday
9:00am - 6:00pm


Wednesday
9:00am - 6:00pm


Thursday
9:00am - 6:00pm


Friday
Closed


Saturday & Sunday
Closed

Synergy Chiropractic

6400 Farmington Rd Suite 114
West Bloomfield Township, MI 48322

(248) 862-2202