Accessibility View Close toolbar

Online Forms

Paun Family Chiropractic and Wellness, P.C. offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Forms

New Patient Form (Chiropractic or Acupuncture) - Please bring this filled out to your first chiropractic/ acupuncture appointment.

Massage New Patient Form (Cash Massage only) - Please bring this filled out to your first massage appointment.

Nutrition New Patient Form - Please bring this filled out to your first nutrition appointment.

Hypnosis New Patient Form - Please bring this filled out to your first hypnosis appointment.

Auto Accident Forms - Please bring this form filled out if you were involved in an auto accident and will be billing to your, or a 3rd party, auto insurance.

DOT Commercial Driver Fitness - Please bring this form filled out to your Driver Exam appointment.


Pain Questionnaires

Please DO answer each question, please DO NOT total it at the bottom. You only need to print the questionnaire if told to do so by one of our office managers.

Low Back Questionnaire

Neck Questionnaire

Hip, Knee, Ankle Questionnaire

Arm, Shoulder, Wrist Questionnaire



Download the Free AdobeReader®