When you first come to our clinic we need you to fill out a "Patient Health Questionnaire."

This gives us some background on your medical history and other important information so we may better treat your pain.

You may download this form, print it out, and fill it out before your first visit to Hillside Chiropractic. Doing so will save you some time the day of your
first appointment.

• Download page 1 of the Questionnaire
• Download page 2 of the Questionnaire
• Confidential Practice Member Profile
  

Thank you and we'll see you here at the clinic!

If you have any questions for Dr. Jeff about chiropractic or if you'd like him to speak at your business or function, call now at 763.241.5393.

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theses documents. You can download it free from Adobe.