New Patient Forms
Download Necessary Forms
At Proactive Chiropractic And Rehab Center in Charlotte, we want to make your visit to our chiropractic office a convenient and efficient experience without a long wait period. Fill out the required paperwork now from the comfort of your own home.
Download New Patient Paperwork Case and Family History
This form helps us obtain your demographic information quickly. It also helps us gather information about your pain and past medical history so we can create a treatment plan that works best for you.
Download New Patient Paperwork Medical Consent Form
This form gives us permission to treat you and solidifies our promise to discuss any risks involved with your treatment.
Download New Patient Paperwork HIPAA Form
This form outlines how your health information will be used in our office and serves as your consent for its use.
Download New Patient Paperwork X-Ray Consent Form
This form gives Dr. Khlebopros permission to perform x-rays during your visit.
