Spinal Care VT

Chiropractic, Decompression & Physical Therapy Forms

We ask every new patient to fill out the following:

• New Patient Info
• Medical History
• Pain Diagram
• Consent to Treat
• Insurance and Financial Policies
• Privacy Policy

In order to be able to treat minors, we need to have this form filled out:

• Consent to Treatment of a Minor

If you would like a copy of your medical records, or would like them sent to the Spinal Care or another office, please fill out the form below and give it to the office that has your files:

• Record Release Request

As always, don’t hesitate to contact the Spinal Care Center or call 802.660.3110 with any questions.