Patient Forms

Welcome Back to Health. Our purpose is to educate and rehabilitate our patients toward optimal health through natural chiropractic care and rehabilitation exercises. The work we do here at Back to Health Chiropractic is very unique and our approach is quite advanced compared to most other chiropractic and physical therapy programs. This allows our patients to achieve results that are unavailable to many other people.

Please fill out the following information so that Dr. Schatzle can let you know if you can be accepted as a patient in our office. If you have any questions, please feel free to ask for assistance. Thank you for this opportunity to serve you.

General Intake Forms

  1. Patient Application Form
  2. Office Policies
  3. Privacy Notice
  4. Consent for Treatment
  5. EHR Intake Form
  6. About Medicare Coverage
  7. Automobile Accident Questionnaire

Nutrition Response Testing Forms

  1. New Patient Information
  2. Health Assessment
  3. Food Intake
  4. Permission and Authorization