Online Patient Intake Forms

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 Intake Form

This let’s us know what’s happened, but perhaps more important, where do you want to take your health?
  Download & Print Form


Minor Consent Form

This is Parental/Guardian consent to treat a minor child
  Download & Print Form


Automobile Accident

If your health issue is the result of a car accident, we need some additional information.
  Download & Print Form


Worker’s Compensation

If your health issue is the effect of an injury at work, this information will help us help you.
  Download & Print Form


Free AdobeReader®

Each 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. Nicholson Asks some important questions of interest to Fulton residents - Chiropractor Fulton Dr. Nicholson Asks...

Can someone who has had back surgery receive chiropractic care?
Yes. Rest assured that we will avoid the surgically modified areas of your spine. However, what we find is that surgical interventions will often produce spinal instability above or below the involved level. This is will be the focus of your chiropractic care.
What's the difference between a "good" drug and a "bad" drug?
As a chiropractor, I see the use of many drugs (legal or illegal) as merely symptom treating. Worse, virtually every drug produces unwanted effects. The effects of chiropractic are largely positive effects. If you're a Fulton parent, consider carefully before giving your child a cough medication, cold remedy or pain reliever so this sort of question doesn't arise in the first place.