100 Year Lifestyle Chiropractor in Atlanta GA
Phone: 404-231-1872

Patient Forms

We offer our patients form(s) online so you can complete it in the convenience of your own home or office.

Click the link New Patient Online Form below, fill out the form completely and leave no blanks, digitally sign and click submit. Forms will automatically be sent to us and uploaded in our software. (Scroll to the bottom of the forms page to be sure that you can sign forms digitally from your computer. If not, you will not be able to complete the process online and will need to complete the forms in the office)

New Patient Online Form

New Patient Paperwork

If you are new to our office, please print and fill out the following 4 pages for you and your family. Bring these with you to your first appointment along with an ID card (Driver's License) and health insurance card if you would like our staff to verify your coverage. Thank you!

Auto Accident Forms

If you have recently been involved in a car accident, please print and fill out this form. This additional information will help us take better care of you!

Office Policies and Procedures

If you are a new patient, please read our Policies and Procedures. Understanding these items will ensure a smooth transition into Crisis Care at our office, and beyond into Lifestyle Care!