Bakke Chiropractic Clinic offers many of our patient forms online so you can complete them in the privacy and convenience of your home.

• 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 appointment.

The following forms are available at this site:

• New Patient Forms (Confidential Information, Health History, Pain Diagram)
• Work Injury
• Car Accident
• Personal Injury (not car related)
• Children's Health History Forms
• HIPPA Information (Patient Privacy Policies)

Important: Please be sure to bring in your latest insurance information with you at the time of your appointment

New Patient Health History Form, Confidential Patient Information and Pain Diagram - Required (3 different forms)

It's important to have our doctors know your health history as well as what brings you to our clinic. We also need basic information about you for our files and we want to know "where it hurts".

Download & Print Form


Injury at Work Form

Did you have a work injury? We need to know where it happened, how it happened and important work contact information. 

Download & Print Form

Moving Vehicle Injury Information

Were you injured in a car accident? We need all the details and information about your injuries so we can provide the most effective care.

Download & Print Form

Personal Injury History and Information

Did you have a fall or some injury not related to a car accident?

Download & Print Form

Health History Forms for Children:

Newborn, Infant (7 mos to 3 yrs), Pre-school and School age...

Required basic information for our records and files and so we can  identify your child's needs, conditions and best treatment approaches.

Download & Print Form

Download & Print Form

Member Wellness Registration Form - "Please join us!"

This form can be filled out to register for access to the member wellness section of the Bakke Chiropractic Clinic website.

• Sign up for our monthly newsletter to keep up on current health issues and news and events in our office.
• Print it out and bring it in to our office or Click Here to register online!
  
• The online newsletter covers many health topics important to you!
  

Please help us make our website more valuable for you. We welcome your comments and suggestions.

Thank you!

Doctors and Staff at Bakke Chiropractic Clinic