Clendenan Chiropractic offers our patient form(s) online so you can complete it in the convenience of your own home or 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 Information Form

If you've never been a patient at our office before, please complete this form.  This let’s us know the history and current state of your health, as well as your insurance information. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Child Consent Form

This authorizes Dr. Clendenan to administer chiropractic care to a minor child under the age of 18 years.

Auto Injury Questionnaire Form

If the reason you are coming in to see Dr. Clendenan is the result of an auto accident, this form gives us the necessary information we need in order to send reports to your auto insurance compay.  Along with this form, we will need the name, address, and telephone number of your auto insurance as well as your claim number.

Download & Print Form

Work Comp Form

If the reason you are coming in to see Dr. Clendenan is the result of an on the job injury and you are claiming workers compensation, this form gives us the necessary information we need in order to send reports to your employer and his worker's comp insurance carrier.  BEFORE making this appointment make sure you have reported the injury to your employer and or supervisor and have WRITTEN authorization to come to our office.

Download & Print Form

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!