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Patient Forms

Core 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 AdobeReaderĀ® 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

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!


Automobile Accident Form

If your health issue is the result of a car accident, we need some additional information.


Release of Records Form

If you have received chiropractic care elsewhere, or have medical records we will need from another practitioner, please sign this release.


Consent To Treat A Minor Form

If your child is under 18, we will need you to sign this release in order for us to treat them

558 E Riverside Dr, Suite 101 | St. George, UT 84790

Office Hours

Monday:

9:00 am-1:00 pm

3:00 pm-6:00 pm

Tuesday:

9:00 am-1:00 pm

3:00 pm-6:00 pm

Wednesday:

9:00 am-1:00 pm

3:00 pm-6:00 pm

Thursday:

9:00 am-1:00 pm

3:00 pm-6:00 pm

Friday:

9:00 am-1:00 pm

Closed

Saturday:

Closed

Sunday:

Closed

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