Skip to content

Online Forms for Peak Performance Chiropractic

We offer our paperwork online so you can complete it in the convenience of your own home. If you have any questions, give our Menands chiropractic office a call.

Online New Patient Intake Form

Click here to conveniently fill out and submit your New Patient Intake Form
Note: Online forms work on most tablets and phones but not all. The intake form should work on all devices using Internet Explorer, Firefox and Chrome.

New Patient Form

Printable – New Patient Intake Form

This lets us know what’s happened, but perhaps more important, where do you want to take your health?

PDF IconDownload & Print Form

Patient History Update Form

Use this form if you have not seen the doctor in more than three months, have a new complaint or have a change in information

PDF IconDownload & Print Form

Empire Plan Patient Summary Form

Fill out this form and bring it with you if your insurance card says “Empire Plan” or “NYSHIP” on it. For the most part, this form is for NYS employees.

PDF IconDownload & 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.

Peak Performance Chiropractic | (518) 472-9130