The Belmont Chiropractor to see - Chiropractor Belmont

Online 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.

Health History

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

 Download & Print Form (page 1)

 Download & Print Form (page 2)

Initial Health Status

If you have HMO insurance, please fill out this form in addition to the 2 pages above for us to process your care.


 Download & Print Form

HIPPA

If you have received chiropractic care elsewhere, or have medical records we will need from another practitioner, please sign this release.

 Download & Print Form

Office Policy

We have made our standard office policy available for you to read.


 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. Nicole Asks some important questions of interest to Belmont residents - Chiropractor Belmont Dr. Nicole Asks...

Can babies with colic be helped with chiropractic?
It's probably one of the times a parent feels the most helpless. But based on the research, chiropractic and colic relief appear to go hand in glove. With success rates in the mid-90% range, more and more Belmont parents are seeing a chiropractor. If you have a baby with colic learn how chiropractic may help.
How long does it take to form a bone spur?
Many who begin chiropractic care think their problem happened "last week when you bent over funny." But pictures of the spine tell a different story. Chiropractors know it can take your body years to deposit the calcium necessary to form a bone spur. It's your body's response to stress due to gravity or joint malfunction. And chiropractic care can help.