Online Paperwork

We offer our paperwork on line so you can complete it in the convenience of your own home. Here are the essential forms we use and why we need them.


New Patient Registration and Case History

This lets us know what’s happened, but perhaps more important, where do you want to take your health?

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This form is a PDF document file.  If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.

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Dr. Todd  Asks some important questions of interest to Capac residents - Chiropractor Capac Dr. Todd Asks...

Where do most Capac residents get their first subluxation?
Being born in a hospital is a common source of subluxation. Trauma from forceps delivery has been replaced with drugs, vacuum extraction, Cesarean section and births that are "scheduled" to fit the workweek routines of Ob-Gyns. That's why we recommend a chiropractic checkup for every Capac newborn.
What's a side effect?
It may sound like a bonus; something extra, but chiropractors know it should more accurately called an "unintended effect," and "unwanted effect" or in some cases an "adverse effect." A pill can't come close to matching your body's ability to create and deliver the essential compounds it needs. That's when it's important to make sure your nervous system is working correctly—the purpose of chiropractic care!