Online Forms

New HIPAA Patient Privacy Policy

Download and print policy.


Ballenger Chiropractic offers our patient form(s) online so you can complete it in the convenience of your own home or office.

  • If you do not already have AdobeReader® 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 Paperwork - REQUIRED

This let's us know the history and current state of your health, and the specifics of your current state of discomfort and/or pain. Please complete all pages to the best of your ability. Thanks!

What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form Please complete the pain questionnaire no more than a day prior to your appointment. Thanks!

Please call the office at
410-252-1000 to receive and submit the new patient information
electronically


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office. The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!