New Patients

Welcome to the new patient center for ChiroHealth.

If you’ve never experienced chiropractic care before, you may not know what to expect when you come to our office for the first time. This section of the website will help you learn the process of becoming a new patient in our office. In this area of the website, you will be able to take care of the items necessary for your chiropractic visit prior to arriving, in the comfort of your own home. If you have any questions at any time, please don’t hesitate to contact us.

We have a variety of services in our office that allow us to individualize care for pain relief, health and wellness, sports performance, health concerns, and more. We look forward to sharing those options with you.


Online Forms

ChiroHealth Rockford 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. We ask that you return these forms 24 hours prior to your new patient appointment. This lets us know the history and current state of your health. What questions, concerns, and goals regarding wellness can we help you with? Let us know!

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Click the link below, then right click and print it out.
  • Fill in the required information.
  • You can fax completed form(s) to 616-863-9486, scan then email them to info@chrockford.com, or drop them off in person at the front desk.


New Patient Paperwork – Required for all patients age 14 or over

Adult History form and Office Policy

New Child Patient Paperwork – Required for children 13 and under

Download & Print Form

FACEBOOK FEED

Comments Box SVG iconsUsed for the like, share, comment, and reaction icons

Any migraine sufferers out there? If so, read this Chiropractic testimonial from Teresa! ⬇

#testimonial #migraines #chiropractic #health #healing #wellness
... See MoreSee Less

Any migraine sufferers out there? If so, read this Chiropractic testimonial from Teresa! ⬇

#testimonial #migraines #chiropractic #health #healing #wellness

Comment on Facebook

If you are dealing with migraine . contact zira_spores on Instagram. she cured mine using mushrooms Microdosing capsules and some other good psilocybin and she also gives out free guide on how to use them.

View more comments

Faith over fear! 🙏 #faith #sundayvibes #God #scripture ... See MoreSee Less

Faith over fear! 🙏 #faith #sundayvibes #God #scripture

𝔽𝔸ℂ𝕋: 𝕋ℍ𝔼 𝔸𝕍𝔼ℝ𝔸𝔾𝔼 ℙ𝔼ℝ𝕊𝕆ℕ 𝕊ℕ𝔼𝔼ℤ𝔼𝕊 𝟜 𝕋𝕀𝕄𝔼𝕊 ℙ𝔼ℝ 𝔻𝔸𝕐! 🤧

However, a person with seasonal allergies may sneeze UP TO 40 TIMES PER DAY! 😳

Save your nose from all those blows and snag this natural anti-histamine 𝕋𝕆𝔻𝔸𝕐! 👃

#sneezing #allergies #natural #holistic #health
... See MoreSee Less

𝔽𝔸ℂ𝕋: 𝕋ℍ𝔼 𝔸𝕍𝔼ℝ𝔸𝔾𝔼 ℙ𝔼ℝ𝕊𝕆ℕ 𝕊ℕ𝔼𝔼ℤ𝔼𝕊 𝟜 𝕋𝕀𝕄𝔼𝕊 ℙ𝔼ℝ 𝔻𝔸𝕐! 🤧

However, a person with seasonal allergies may sneeze UP TO 40 TIMES PER DAY! 😳

Save your nose from all those blows and snag this natural anti-histamine 𝕋𝕆𝔻𝔸𝕐! 👃

#sneezing #allergies #natural #holistic #health