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Request An Appointment

405-735-2744

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

Filling out paperwork before your appointment will save you approximately 15 minutes in the waiting room.  Please fill out the forms that apply by clicking the links below.  Thanks!

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Forms (ages 13 and older)

Introduction Patient Case History

Functional Rating Index

Consent

Patient Privacy Notice

Acknowledgement Patient Notice


For children ages 0-12, please print and fill out the following forms:

Introduction Patient Case History

Consent for Treatment of Minor 

Patient Privacy Notice

Acknowledgement Patient Notice


If you have been injured on the job or in an automobile accident, please fill out the following forms:

Accident/Injury Questionnaire

Consent

Patient Privacy Notice

Acknowledgement Patient Notice


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!

Download & Print Form



Download the Free AdobeReader®


 

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