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Front Desk Ballard Family Chiropractic
New Patient Forms

Please fill out the appropriate New Patient Intake Forms and bring them with you on your first visit. The information you provide will help Dr. Ballard develop her individual care plan for you or your little one. Be sure to complete each section as accurately as possible, and pay particular attention to your goals! This information also assures that we are on the same page as a team,  so we can provide you with the best chiropractic, nutrition, and wellness care possible!

Click the links below to jump to the appropriate section for your needs. If you have any questions, we are always here to help!

Pediatric Chiropractic

Pediatric Chiropractic Forms

(please print the informed consent along with the age appropriate forms)

Birth - 3 yrs Intake Forms

Informed Consent

4 - 8 yrs Intake Forms

9 - 13 yrs Intake Forms

Adult Chiropractic (13 & Up)
Pregnancy & Prenantal

Adult Chiropractic Forms (Ages 13 & Up)

(Please print all forms)

Adult Intake


Informed Consent

Health Status Questionnaire

Prenatal & Pregnancy Forms

(Please print all forms)

Pregnancy Intake Forms

Informed Consent

Health Status Questionnaire

Nutrition Forms for Functional Medicine visit

Please fill out a records release for each doctor you've had recent testing with.

Be sure to return these forms to our office, via email or fax, AS SOON AS POSSIBLE prior to your visit.

Please do NOT mail through the postal service. 

(Please print off all FIVE (5) PDFs below.

Nutrition Intake Forms

Records Release

Auto Payment Agreement

Informed Consent

Toxicity Questionnaire

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