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Chiropractic care for Wellness

New Patient Paperwork

The Other Side of Medicine 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.
  • Fax us your printed and completed form(s) or bring them with you to your appointment.

NEW PATIENT HEALTH HISTORY FORM - REQUIRED

  1. Functional Medicine
  2. Chiropractic

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!

FUNCTIONAL MEDICINE

  1. In Office Appointment
    After you have called our office and secured an appointment time, you will be sent a link to our HIPPA compliant, online patient registration forms and questionnaires. Fill this form out asap to enable Dr. Krystosik to review it before your initial appointment.
  2. Phone Consultation
    1. Brief Phone Consultation
      Fill Out Form Online CLICK HERE
    2. Comprehensive Phone Consultation
      You will receive an email conformation once your order has been processed with a link leading to the functional medicine information form that is required to be filled out and returned prior to your consultation.

CHIROPRACTIC NEW PATIENT FORM

OFFICE HOURS


Monday
10:00am - 6:00pm


Tuesday
3:00pm - 6:00pm


Wednesday
10:00am - 6:00pm


Thursday
3:00pm - 6:00pm


Friday
9:00am - 12:00pm


Saturday
Closed

The Other Side of Medicine
163 East Aurora Road Suite 2
Northfield, OH 44067
(440) 519-1766

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