Preferred Bellingham Provider
HIGHLEY RELAXING CHIROPRACTIC
  • Welcome
    • Meet Our Staff
    • Office Updates/COVID-19 Response
  • Why Chiropractic?
  • Hours
  • Contact
  • Paperwork
    • New Patient Paperwork
    • Established Patient Update
    • MVA or Work Injury
  • Pay Your Bill Online

New Patient Paperwork

The New Patient Intake Form is required for all new patients. If you are scheduling for a minor or are a minor yourself, we will need a parent or guardian to fill out the consent form.  If you were involved in a motor vehicle accident or sustained an injury at work please also fill out the forms listed under the MVA/Work Injury page on this site.

You can print your paperwork out and bring in for your initial visit. Please arrive five minutes early so we can put your chart together. You may also fax your completed paperwork to (360) 647-5587 or send by email to 
hnchiro@yahoo.com
New Patient Intake Form
File Size: 1406 kb
File Type: pdf
Download File

Consent to Treatment of a Minor
File Size: 17 kb
File Type: pdf
Download File

Highley Chiropractic
2029 James St., Bellingham, WA 98225
​Phone (360) 676-4488      Fax (360) 647-5587
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