The San Jose Chiropractor to see - Chiropractor San Jose

Online Paperwork

We offer our paperwork on line so you can complete it in the convenience of your own home. Here are the essential forms we use and why we need them.

Health History and Future

This let’s us know what’s happened, but perhaps more important, where do you want to take your health?
Download & Print Form

Pediatric Health History and Future

Same as the form above, but for kids!
Download & Print Form

Informed Consent for Chiropractic Treatment and Care

Please read and sign this form.
Download & Print Form

Privacy Practices Acknowledgement

Please read and sign this form.
Download & Print Form

Free AdobeReader®

Each form is a PDF document file. If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.

New Massage Patient Intake Form

Please complete and sign this form.
Download & Print Form

Print PageEmail a FriendMake an AppointmentEmail Doctor

Dr. Jessica Asks...

Do chiropractors prescribe medications for the pain?

No. Chiropractic is a drug-free approach to better health. Instead, we rely on natural methods. We can show you how to use ice to control pain. When properly applied, ice can have an analgesic effect without the unwanted and sometimes dangerous effects of pain medications.

Can chiropractic relieve PMS?

If you have subluxations, especially in the lower spine that impair nerves that direct and monitor the reproductive and hormonal systems, chiropractic could be helpful. Undetected subluxations may also be responsible for pelvic pain, incontinence, sexual dysfunction and even infertility. Maybe chiropractic can help. Find out!