Online Patient Forms
At Family Chiropractic, we offer patient forms online so you can complete them in the convenience of your own home or office. Getting your paperwork done before your appointment means less time in the waiting room and more time with Dr. Adam Fasick.
Download Your New Patient Form
New Patient Form – Download & Print Form
If you do not have Adobe Reader® installed on your computer, Click Here To Download.
Once your form is complete, you can fax it to our office or bring it with you to your appointment.
Why Complete Your Forms Before Your Visit?
Filling out your paperwork ahead of time gives you the chance to gather your information without feeling rushed, and it gives Dr. Adam Fasick a clear picture of your health before you arrive. Your form will ask about:
- Your current symptoms, when they started and what makes them better or worse
- Past injuries, surgeries and accidents, including auto accidents and work injuries
- Your medical history, medications and family health history
- Your daily habits, activity level and health goals
- Your contact and insurance information
The more complete your answers, the more time we can spend on what matters most during your visit: understanding your concerns and getting you started on care.
What to Bring to Your Appointment
Along with your completed form, please bring your driver’s license and insurance card. We’ll make a copy of your insurance card so we can help estimate your coverage. Learn more on our Payment Options page.
To prepare for your appointment, read about your first visit and what to expect, or browse our FAQs. You can also explore our chiropractic services and the conditions we treat.
Please use this page for paperwork only. Do not email personal health information; specific health questions will be addressed during your appointment.
Online Forms FAQs
Do I have to fill out forms before my first visit?
It isn’t required, but it’s helpful. Completing the new patient form ahead of time saves time at your appointment and helps Dr. Adam prepare for your visit.
How do I submit my completed form?
You can fax your printed and completed form to our office or bring it with you to your appointment.
What if I can’t open the PDF?
You’ll need a PDF reader such as Adobe Reader®, which you can download for free using the link on this page. If you still have trouble, call us at (517) 376-6836.
What information will the form ask for?
The form asks about your symptoms, past injuries, medical and family history, health habits, contact details and insurance information.
What else should I bring to my appointment?
Please bring your driver’s license and insurance card along with your completed form.
Can I fill out the form at the office instead?
Yes. If you aren’t able to complete it beforehand, just let our front desk know when you arrive and we’ll help you get started.
Ready for Your First Appointment?
Once your forms are ready, schedule your visit with Family Chiropractic in Howell, MI . Call (517) 376-6836 or request an appointment online.