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


New Massage Patient Intake Form

Please complete 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.

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Dr. Jessica  Asks some important questions of interest to San Jose residents - Chiropractor San Jose 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.
What's the difference between maintenance, prevention and wellness?
Maintenance chiropractic care is an attempt to keep a dynamic, ever-changing and adapting organism (you) in a static relationship with your environment. Preventive chiropractic care is mostly about early detection. Wellness chiropractic care is an attempt to optimize our health and be all that you were designed to be.