Gonstead Family Chiropractic offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

• If you do not already have AdobeReader® installed on your computer, Click Here to download.
• Download the necessary form(s), print it out and fill in the required information.
• Fax us your printed and completed form(s) or bring it with you to your first appointment.

New Patient Health History Forms - Required

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!  Choose from the following forms according to which best fits your needs.  If you have questions about which form to choose please call our office at (760) 863-0435.

New Patient (Cash/Health Insurance/Medicare Patients)

Download & Print Form

New Patient (Personal Injury/Auto Accident)

Download & Print Form

New Patient (Pediatric - Ages 1 day to 5 years)

Download & Print Form

Paciente Nuevo en Espanol

Download & Print Form

 Member Wellness Registration Form - Optional

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!