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Vitality Chiropractic offers our patients all of our forms 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 filled out with you to your appointment.


New Patient Intake Form - Required

This form is for any patient who has never been into our office before.

It lets us know the history and current state of your health. What questions, concerns, and/ or goals regarding health and wellness can we help you with? Let us know!


Auto Accident / Injury Forms - Required for any patient who has been in a car accident within the last month.  If you are seeing Dr. Verhunce due to an injury: automobile, work, or other, please fill out this paperwork and bring it filled out and completed into the office for your first visit.



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.

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