Nygren Chiropractic & Acupuncture

Dr. Nichole Nygren DC Diplomate Acu
Dr. Nichole Nygren DC Diplomate Acu
SAVE TIME:
PRINT, READ AND COMPLETE THESE AT HOME
SAVE TIME:
PRINT, READ AND COMPLETE THESE AT HOME
Step 1: Identify what type of patient you are and read the forms that you need.
Step 2: Scroll towards the bottom of the page to find the forms in PDF format.
Step 3: Double click on the PDF forms icon to open it
Step 4: Print them.
Step 5: Using an ink pen, fill them in completely and bring them to your appointment.
It's that easy!!
Our Privacy Notice is also available below for you to view, as well as our Muscle Testing Leaflet and Acupuncture Leaflets. You do not have to print or sign anything on these forms.
New Patients (7 and older):
Please print, read and fill out the following forms:
1. New Patient Form
2. Office Policy Form
For Medicare Patients Only:
Addition to the above forms, please print, read, and fill out the following form:
1. Notice of Medicare Coverage Form
Child New Patient (birth-6):
Please print, read and fill out the following forms:
1. Child New Patient Form
2. Office Policy Form
New Patient for Fertility:
Please print, read and fill out the following forms:
1. New Patient Fertility Form
2. Office Policy Form
Smoking Cessation Acupuncture Program:
Please print, read and fill out the following forms:
1. Smoking New Patient Form
2. Office Policy
3. Acu Smoking Rules (read only)