Patient Online Forms

Schieber Chiropractic & Acupuncture offers our patient forms online so you can complete them in the convenience of your own home or office.

  • If you do not already have Adobe Reader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Form - Required

The New Patient Health History Form provides us with information regarding the history and current state of your health.  What questions, concerns and goals regarding wellness can we help you with?  Let us know!

Online intake form

Download & Print Adult Patient Form

Download the Free Adobe Reader®