Pend Oreille Chiropractic

Patient Intake Form

Welcome to our online Patient Intake Form. The information you fill in will be sent directly to our office, speeding up your office visit and allowing us to better serve your healthcare needs. We at Pend Oreille Chiropractic are looking forward to seeing you. Please let us know if you cannot make the appointment, as we do have a waiting list for people to get in. If the intake form is not filled out the day before the appointment, (Friday if appointment is on Monday) we will have to reschedule. If I do not receive it, it leads me believe you do not need the appointment any longer.

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