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Patient Forms

If you have an appointment scheduled with one of our doctors or therapists, please print and fill out the appropriate forms below and bring them with you to your appointment.  If you are unable to fill out the forms beforehand, just arrive 20 minutes prior to your scheduled appointment time to fill them out in the office.
Not sure which forms apply to you? 
Simply call the office for assistance (408) 448-4445. 

Chiropractic & Rehabilitation

Forms to be completed by ALL New Patients:
New Patient Intake Forms
Pre-Treatment Questionnaire

Additional forms to fill out if you meet the following criteria…

For patients with Kaiser, American Specialty Health, or an HMO:  
Initial Health Status Form_ASH-HMO
For auto accident patients:  Auto Accident Intake Form
For Medicare patients:  Medicare Notice for Chiropractic Services

Massage Therapy

for Lisbeth Geertsen:  Massage Intake Form_Flair for Care
for all other massage therapists: PSS Massage Client Intake

Other Services

For High School Athlete Sport Physical:
Sport Physical Forms