Patient Info

New Patient Info for Ashworth Chiropractic & Acupuncture Clinic

The first step is to determine if the services we provide in our office are right for you and your condition. During our discovery process we will review your case to determine whether or not you are a candidate for our type of care.

We will respect the goals you set for yourself. We will do our best to make your appointments efficient and effective as we do honor your time. We will try answer your questions thoroughly, and Dr. Wilson and Dr. Kim will always refers to other health care specialists when indicated by your tests and noted progress. We want nothing more than for you to be happy with your health and care in our office.

 

Forms you will need for your first visit

Patient Information Form
In an effort to save you time in the office you may print these forms and fill them out at home. All patients must fill out and sign the Patient Information Form.

Accident/Injury Form
If you were involved in an accident where injury occurred please fill out this form.

Sports Physical Form (IAHSAA)
If you are coming in for a sports physical please bring the one supplied by your school if it is different from the IAHSAA form here.

 

*If examination or treatment is for an individual under the age of 18 years a legal guardian must sign all forms as well.

*If you are unable to print these out ahead of time, please arrive 15 minutes prior to your scheduled appointment.

 

Nondiscrimination and Accessibility Requirements