Innovative Health offers our patient forms online so that you can save time at your visit by completing them before you even arrive at our chiropractic office.
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Download form(s), print, fill in, and bring them along to your appointment.

1) New Patient Health History Form – Required

This outlines the history and current state of your health. We also encourage you to write down any questions that you have, so that we can be sure to cover them during your appointment. Choose the appropriate form based on the patient’s age.

Adults and Children over 6 years of age
Children ages 6 and under

2) Patient Reactivation – Required

If you are a returning patient, but haven’t been to our office within the past 3 months, we will need to collect more recent health information. Please choose the appropriate form based on how long it’s been since your last visit (if you’re unsure, please don’t hesitate to call us at 715-355-4224).

Your last visit was between 3 months and 1 year ago
Your last visit was more than a year ago

3) Insurance Benefits Worksheet – Recommended

This worksheet helps you to understand your insurance coverage by outlining the questions you should ask your insurance provider. It is important to know that it is your responsibility to verify your coverage and understand your financial share of the services we provide. We strongly recommend that you bring this completed form with you to your first appointment.

Download & Print Form

4) Medical Records Request

To transfer medical records between our office and another provider.

Download & Print Form

5) Workers’ Compensation

If your visit to our office was because of an injury that happened at work, please use this form. It is required for all Workers’ Compensation claims.

Download & Print Form

6) Auto Accident History

If your visit is due to an injury sustained in an auto accident, please use this form. It is required for all auto accident claims.

Download & Print Form

7) Personal Injury Supplement

Our staff will let you know if this form is required as a supplement to Form #1 (Patient Health History).
Download & Print Form

8) Functional Medicine & Nutrition Forms

Please only complete the forms that the doctor or staff asks you to complete.

Form A:  New Patient Information Form (Download & Print)

Form B:  Health Appraisal (Download & Print)