Canton Chiropractic Life Center offers our patient form(s) online so they can be completed 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.
Select Disability Index Specific to your condition
Must be Filled out 1st Day
This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!
To view the Forms, you will need Adobe Acrobat Reader. If you do not have Adobe Acrobat Reader installed on your computer, please