Online Forms

We offer our paperwork on line so you can complete it in the convenience of your own home.  Please print out, complete and bring to your first visit. 


New Patient Paperwork

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

Online Form (click to fill out and submit electronically)


Massage Paperwork

If you are interested in massage, please fill out the following form

  Download & Print Form

  Download & Print Policies Form


Medicare Patients

  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.




Dr. Derrick Hau, 1610 C St. Ste 103, Vancouver, WA | (360) 694-0300

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Dr. Hau Asks some important questions of interest to Vancouver residents - Chiropractor Vancouver Dr. Hau Asks...

How come medical doctors don't recommend chiropractic?
That's changing. Years of prejudice and bias are giving way to research showing the benefits of chiropractic care. As more and more Vancouver folks seek alternatives to drugs and surgery, more and more medical practitioners are referring their patients to chiropractors.
What controls every cell, tissue and organ of your body?
DNA? Wrong. Immune system? Wrong? Hormones? Wrong. It's your nervous system, consisting of your brain, spinal cord and all the nerves of your body. When a chiropractor sees a Vancouver patient with say, stomach problems, we want to know why the brain is unable to properly control and regulate the stomach. Which prompts us to examine the nervous system—the focus of chiropractic care.