New Patient Paperwork

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

New Patient Forms

  • New Patient Intake (Cash & Insurance)

    Click to Complete

  • Motor Vehicle Collision Intake

    Click to Complete

  • On-The-Job Injury Intake

    Click to Complete

  • Pediatric Intake (Anyone Under 18)

    Click to Complete

Established Patient Forms

  • Re-Exam Form

    Click to Complete

  • Re-Exam & Patient Update Form

    Click to Complete

  • Functional Rating Index

    Click to Complete

OFFICE HOURS

Monday
9:00am - 1:00pm
3:00pm - 6:00pm

Tuesday
9:00am - 12:30pm
3:00pm - 5:00pm

Wednesday
9:00am - 1:00pm
3:00pm - 6:00pm

Thursday
9:00am - 1:00pm
3:00pm - 6:00pm

Friday
9:00am - 1:00pm

Saturday & Sunday
Closed

Atlas Family Chiropractic

2310 Mildred St W # 130
University Place, WA 98466
P: (253) 460-4244
F: (877) 841-5137