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?

 Download & Print Form


Medicare Patients

 Download & Print Form

Why we don't accept assignment from your insurance company?

 Download & Print Form

 


 

 

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

What does a chiropractic adjustment do?
Chiropractic adjustments give your spine a little "nudge" at the right place, right time and the right direction so your body can use that energy to "right" itself. With a schedule of consistent chiropractic visits, a new, healthier spinal pattern emerges.
How does headache medication find the headache?
It can't! Chiropractors know that when you ingest a drug and it enters your bloodstream it numbs or deadens your entire body. Chiropractic adjustments, on the other hand, are specific, targeted and delivered with precision.