Online Forms

Vitality Chiropractic offers our patient form(s) online so they can be completed it 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) at 206-212-7455 or bring it with you to your appointment.

New Patient Intake Form - Required

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!

Download and Print Form

Injury Intake Form - Optional

If you are seeing Dr. Bonnie due to an injury: automobile, accident, or other, please fill out this paperwork as well and bring it into the office for your first visit.

Download and Print Form

Hormone Questionaire Form - Optional

If you are seeing Dr. Bonnie for a Hormone Consultation, please fill out this paperwork and bring it into the office for your first visit.

Download and Print Form

HIPAA - Notice of Privacy Practice

We are happy to provide this HIPAA compliant notice of our privacy practices for you.  This document is a simple explanation of your rights about how, when, and why your health information may be disclosed.  Please feel free to contact our office with any question or concerns you may have about this notice.

Download form for your records