Online Forms

Back To Health Non-Surgical Pain Solutions offers our patient form(s) online so they can be completed 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 Health History Form – General

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!

Female New Patient

Male New Patient Form

If the patient is under the age 18, please fill our New Patient paperwork listed above AND under age 18 forms here.

Worker’s Compensation (or) Personal Injury paperwork needs to be filled out in our office.

Download the Free AdobeReader®