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Exclusive Offer

New Patients Receive a Free Consultation

New Patient Online Forms to Print

Harrah 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 Adobe Reader® 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.



New Patient Health History Form - 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!

Download & Print Form

New! Patient Health History - Detailed Form 

DO NOT FILL OUT UNLESS TOLD TO DO SO

This new form is very detailed so to review this file and fill it out, click on the appropriate link below.
Download & Print in Adobe Reader Format

Download & Print in Microsoft Word Format


Eating Practices For Optimal Health

Vitally Important information to help guide you to Optimal Health from your Eating Habits...

Download this information below.

Download in Adobe Reader Format

Download in Microsoft Word Format


ABN-Medicare Form

Download & Print Form


Consent to treat a minor Form

Download & Print Form


Personal Injury & Workers Comp Form

Download & Print Form


Privacy disclosure Form

Download & Print Form


Terms of Acceptance Form

Download & Print Form 


Download the Free AdobeReader®