Application for Treatment Forms

Borges Chiropractic offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic office.

  • 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.

New Patient Health History Form (Paper) -  Instructions for PatientAlly online registration is on the previous tab

Borges Chiropractic fax 530.544.5802

Borges Chiropractic email - [email protected]

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

Additional Forms

Download & Print Form Neck Index

Download & Print Form Lower Back Index

Download & Print Form Patient Record Disclosure

Download the Free Adobe Reader®

Sign-up using the form or call us at (530) 544-5800 to learn about our latest offers!

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