Online Forms

Adjust To Life offers our patient forms online so they can be completed it in the convenience of your own home or office.

You can download and print out these three pages, then fill them out and bring them in to our office on your first visit. 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!

Adult Intake Form

Patient Health History Form for Children

You can download and print out these three pages, then fill them out and bring them in to our office on your child's first visit (up to age 16).

Pediatric Intake Form

Patient History Form for Massage

You can download and print out these two pages, then fill them out and bring them in to our office on your first massage visit.

Massage Intake form

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!