DCH Health System
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Patient Forms
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For your convenience, our patient forms are available for download to be filled out and submitted to us prior to your first appointment.

How to Download and Send Patient Forms:

  • Click on the links below to download the appropriate form.
  • Fill out the form by typing in your information.
  • Save the form as a PDF to an easy to remember place on your computer.
  • E-mail the saved and filled out form as an attachment to optherapy@dchsystem.com prior to your appointment. 
    You can attach and send all your necessary forms in one e-mail.

Or, you can choose to print out and bring the completed forms with you to your appointment.

To download the forms, you will need the latest version of Adobe Reader. Click on the icon below to download the latest version.

General Information Forms

Patient History

Pain Questionnaire

Communication Authorization

Injury Specific Forms

Neck

Back

Arm

Leg




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