Digital Patient Intake for Independent Chiropractic Practices
Collect pain assessment, injury history, and treatment consent digitally — before your patients arrive for their adjustment.
New chiropractic patients fill out extensive pain and injury history on paper. Your staff deciphers handwriting and re-enters data. Auto accident and workers comp cases need even more detail.
Free plan available · No credit card required · 14-day trial on paid plans
Built for Independent Chiropractic Practices
- Pricing designed for solo chiropractors and small practices — not franchise pricing
- No contracts, no setup fees. Start free and scale as your practice grows.
- Works alongside your existing chiropractic software — no switching required
Save time on every patient visit
Digital intake eliminates manual data entry, reduces errors, and lets your staff focus on patient care.
12+
Staff hours saved per month
5 min
Average patient completion time
Complete pain assessment data before the first visit — no guesswork
Review injury history, imaging results, and treatment goals before the adjustment
Built for Chiropractic Intake
Pre-built fields designed for the specific needs of your chiropractic practice.
Pain Location
Neck, upper back, lower back, shoulders, hips, extremities
Pain Severity (1-10)
Current pain level on standard scale
Injury Cause
Auto accident, work injury, sports, gradual onset, other
Previous Chiropractic Care
Yes/no with provider and date fields
Treatment Goals
What do you hope to achieve with chiropractic care?
Treatment Consent
Informed consent for chiropractic adjustment
Up and running in minutes
Three simple steps to digitize your chiropractic patient intake.
Create Your Form
Use the drag-and-drop builder with pre-built chiropractic sections. Add specialty-specific fields and customize everything to match your practice.
Share With Patients
Send patients a simple link before their appointment. They complete forms on any device - no app, no login. Auto-save protects their progress.
Review Submissions
View completed intake forms in your admin dashboard. Search, filter, and mark as reviewed - all before the patient arrives.
Everything your chiropractic practice needs
Purpose-built features for modern chiropractic patient intake.
Pain Assessment Intake
Structured pain location, severity, and onset fields. Get a complete picture before the first adjustment.
Injury History Collection
Auto accident, workers comp, and sports injury details. Capture referral and attorney information when applicable.
Treatment Consent
Digital informed consent for chiropractic care. Timestamped acknowledgment stored securely.
HIPAA-Compliant Security
AES-256 encryption and complete audit logging. Meets all HIPAA requirements for healthcare data.
Frequently asked questions
Common questions about PatientForms.io for chiropractic practices.
Still have questions? Reach out to our team
Ready to modernize your chiropractic intake?
Join hundreds of independent practices that have eliminated paper intake forms. Start free - upgrade when you're ready.
- Free plan available - no credit card required
- HIPAA-compliant from day one
- Set up your first form in minutes