Patient Forms - Natural Life Chiropractic

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Patient Forms

Patient Forms

At Natural Life Chiropractic, all visits are recorded electronically.

All New Patients and Returning Patients who have not yet visited our new building:
Please fill out the
Patient Information Sheet, Health History,  Patient Intake, and Meaningful Use forms.  

The new patient paperwork is four different pages online through the above links and, ideally, we need them 48 hrs in advance before your appt. You'll need the password Natural123 to access the paperwork and note the 'N' is capitalized. 

*Medicare patients: Please make sure your top three areas of complaint reflect the SPINE ONLY! (Neck, Upper Back, Mid Back, Low Back, Pelvis, Sacrum) Medicare only recognizes spinal issues.  Dr. Orwick will be happy to address any extremity issues at your first visit.  If you have current images of your spine (cervical, thoracic, lumbar, pelvis or sacrum) please bring hard copies and reports if available. We should be able to go over them on your follow-up visits. Note: we are electronically connected with SimonMed and Radiology Ltd.

If you cannot fill out the forms online, please let us know as soon as possible and call us with the insurance information so that we have time to verify your benefits for your appointment. We may need you to come in a full hour before your appointment time if you can't do the online forms. 

We apologize in advance for any questions that seem repetative; it relates directly to the complexity of our medical software.  Please take the time to answer all questions fully.  In the future, check-in is going to be such a breeze that we know you won’t mind a little work to prepare!  Please watch the 12 minute education video (Welcome Video) before your visit to get the most out of your facetime with Dr. Orwick.  She would much rather be able to focus on you and your individual issues than spend the time discussing general foundational information.
New Patients: Please be at the clinic 20 min. prior to your appointment time.

You can submit the above forms securely online, but you can also fill in the forms, print, and send by "Snail mail" if you prefer, to:
Natural Life Chiropractic 7235 N. Paseo del Norte, Tucson, AZ 85704
or by Fax – (520) 740-1776
or you may bring them to our office at least 24 hours before first visit.

***If the required paperwork is not received 24 hours in advance, we will need to reschedule your appointment.***

Please read the following forms and be prepared to sign an electronic version at your first visit.
HIPPA, Consent to Treat, Financial Agreement

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