New Patient Instructions


Prior to your first visit, we need the following forms and information filled out from this packet:

  • A copy of your medical records or a signed medical release form. It is most important that we have as complete an understanding as is possible of your history, prior and concurrent care. If you have any questions about this, please call our office.
  • The New Patient Intake Form with your personal information and history.
  • Signed releases/forms for the following:
    • Records from prior care in the event we need to request these from other sources.
    • A Medical Release that acknowledges your understanding about the basis for the care provided
    • Informed Consent for Chiropractic Functional Neurological care. It is important you understand the recommendations for care and your responsibilities. If you have any questions about this, please ask!
    • Consent for video recording. We do use video as part of the patient care records in many cases, but not all. We treat these records as we do all others, respecting the confidentiality of those we care for.


The Professional Services Form will be filled out upon your arrival if you are paying by credit card. You do not need to fill this out before your first visit.


If you are coming from out of town, you can stay at a local hotel that is listed on Travel Resources. Please review the FAQ page on the site for more information.

2014 Lakernick Brain Center
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