WORD Version (Fill out in WORD, Print, and Bring with you)
If you have Microsoft WORD then you can follow these steps:
1. Download the form(s) needed. Only do the first questionnaire (case history) unless asked to do the others!
2. Open them in Microsoft WORD
3. Fill out the forms in WORD
4. Print them
5. Bring them with you
!CASE HISTORY Electronic Fill Then Print[...]
Microsoft Word document [84.0 KB]
!Harper Health Indicator Test - Electron[...]
Microsoft Word document [41.3 KB]
!SYMPTOM SURVEY FORM (Maestro) - Electro[...]
Microsoft Word document [89.8 KB]
- - - OR - - if Microsoft WORD Is not an Option - - then - - -
PDF Version (Print, Fill out by Pen, and Bring with you)
If you DO NOT have Microsoft WORD then you can follow these steps and fill them out manually:
1. Download or Open the three (3) Forms needed (PDF). Only do the first questionnaire (case history) unless asked to do the others!
2. Print out the Forms
3. Fill them out by Pen
4. Bring them with you
PDF Version (Print, Fill out with Pen by Hand, and Bring with you)
CASE HISTORY Electronic Fill Then Print [...]
Adobe Acrobat document [291.2 KB]
PRINT FIRST - Harper Health Indicator Te[...]
Adobe Acrobat document [354.9 KB]
PRINT FIRST - SYMPTOM SURVEY FORM (Maest[...]
Adobe Acrobat document [353.5 KB]
NEXT, READ our PATIENT INFORMATION PRIVACY POLICY before your appointment. This step applies to all new patients. THEN, download, print and sign EITHER the "Agree" or "Disagree" to our privacy policy and bring to your first appointment.
Microsoft Word document [101.5 KB]
Microsoft Word document [65.5 KB]
Microsoft Word document [66.0 KB]
Other Handouts - - Not Required for New Patients
ImmunizationExemptConscience.pdf
Adobe Acrobat document [16.5 KB]
ImmunizationExemptionReligious.pdf
Adobe Acrobat document [12.8 KB]
Available at:
Denito Chiropractic Clinic, PC
408 N Allen Dr
Allen, TX 75013
(972) 727-8947
Practice Hours
Mon 3:30pm - 7:30pm
Tue 12:00pm - 4:00pm
Wed 8:30am - 12:30pm
Thur 12:00pm- 4:00pm
Fri 8:30am - 12:30pm
Sat 10:00am - 2:00pm
Sun CLOSED
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ShareDISCLAIMER: Information, resources or tools contained within are not designed to self-diagnose or self-treat. Diagnosis and treatment of all health conditions should only be performed by your doctor of chiropractic or other licensed health care professional.
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