New Patient Forms at Young Chiropractic & Acupunture Center

To save time on your first visit, click on the link below to download the New Patient Forms. You can either email them to us or print them and bring them in with you.

Every browser and every system are different. Some will automatically download the forms and others will open the form in a new window.

Once the form opens (or starts to download):

  1. Be sure to save them to a place on your computer, where you can easily find it.
  2. When saving, please change the name of the file to your name and be sure it has the .pdf extension.
  3. Once saved, please fill in all pertinent fields. Note: For your protection, signatures, social security #s and insurance info is to be filled out by hand, at the office on your first visit.
  4. Once the forms are filled out and saved, you can then attach the file to an email, or print it and bring it in with you. (Every email brower is different. Most use a paperclip as the icon for attaching a file.)
  5. When you come into the office, you can add your signature and other information to the forms.

If you wish to fill the forms on a tablet or smartphone you will need to download Acrobat Reader from your app store.

Click here for New Patient Forms in PDF format


Young Chiropractic & Acupuncture
3470 Hampton Avenue, Suite 102
St. Louis , MO. 63139
Phone: 314.781.7336 • Fax: 314.781.4241

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