New Patient Forms

Patient Forms

If this is your first time visiting 22 Health, please fill out the necessary new patient forms and email the completed forms to brian@my22health.com. If you prefer to complete the forms at our office, please plan to arrive 15 minutes prior to your appointment.

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Chiropractic Form

If this is your first time seeing a 22 Health doctor, please fill out and complete our New Patient Form. Should you have any questions, please do not hesitate to contact us directly.

If the patient is under the age of 18 years old, a parent or legal guardian consent is required in order to assess or treat the child. Minor Consent Form.

Auto Accident Forms

If you have recently been injured in an auto accident, please fill out and complete our Auto Accident Form and PIP Application and Disclosure. Should you have any questions, please do not hesitate to contact us directly.

Massage Therapy Form

If you are interested in a massage by one of our licensed massage therapists, please fill out and complete our Massage Therapy Form. Should you have any questions, please do not hesitate to contact us directly.

Weight Loss Form

If you are interested in a massage by one of our licensed massage therapists, please fill out and complete our Weight Loss Form. Should you have any questions, please do not hesitate to contact us directly.