ACI Clinic Forms

Below are ACI Clinic forms. Please download and complete the forms before your first appointment. You may send the forms via email or bring them with you at your appointment. If it is not convenient for you to download the forms, please arrive 15 minutes earlier and complete the forms at the front desk of ACI Clinic.

Registration
File Size:	755 kb
File Type:	pdf

Download File

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Pain Diagram
File Size:	635 kb
File Type:	pdf

Download File

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General Health Inquiry
File Size:	446 kb
File Type:	pdf

Download File

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Women's Health Inquiry
File Size:	457 kb
File Type:	pdf

Download File

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HIPAA Consent
File Size:	318 kb
File Type:	pdf

Download File

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Acupuncture Consent
File Size:	488 kb
File Type:	pdf

Download File

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Chiropractic Consent
File Size:	340 kb
File Type:	pdf

Download File

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Health Insurance Information
File Size:	278 kb
File Type:	pdf

Download File

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Car Accident Intake Form
File Size:	347 kb
File Type:	pdf

Download File

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