Admitting Paperwork

We offer our paperwork on line so you can complete it in the convenience of your own home. Here are the essential forms we use and why we need them.


Patient Intake Form

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


Personal Injury Intake Form

If your health issue is the result of a car accident, we need some additional information.
 Download & Print Form


Worker’s Compensation Intake Form

If your health issue is the effect of an injury at work, this information will help us help you.
 Download & Print Form


Nutritional Information Intake Form

Provides us with important information about your nutritional health.
 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.

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Dr. Gene  Asks some important questions of interest to Yakima residents - Chiropractor Yakima Dr. Gene Asks...

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.
Are aches and pains good or bad?
While aches or pains may be unpleasant, they're merely warning signs. As a Yakima chiropractor, I see this all the time. The pain is not the problem! It just means a limitation has been reached and something needs to change. That's when we get to work correcting the underlying cause.