Forms

Online Forms

textWe are now offering our forms online to save you time! Below you will find intake and consent forms for all of our services that you can view and download. You can:

 

  • Print the forms, fill them out by hand, and bring them to your appointment

  • Fill out the forms electronically, print them, and bring them to your appointment

 

Chiropractic

Initial Visit Questionnaire
Consent Form

Consent to Treat a Minor (for anyone under the age of 18)

 

Acupuncture

Initial Visit Questionnaire
Consent Form
Acupuncture Intake Form

Consent to Treat a Minor (for anyone under the age of 18)

 

Massage Therapy

Initial Visit Questionnaire
Consent Form

Consent to Treat a Minor (for anyone under the age of 18)

 


 

Medical Information Release Forms

Below are forms that can be used if you need medical information sent to Kaiser Permanente or to another provider outside of Kaiser Permanente. All requests related to your medical records are processed through the Medical Records department at Kaiser Permanente. If you have questions please contact the Medical Records department at 303-404-4700.

 

Send Records to Kaiser Permanente

Release Kaiser Permanente Records