Patient Forms

Save some time in the office! Below you will find some of the most common forms that you can download and complete prior to arriving in the office. Please note: You may be required to present your insurance card upon arrival so please plan on bringing your card with you.


Existing Patient Forms

Patient Information Sheet – Has it been at least 4 months since your last visit to our office, or is it your first visit of the new year? If so, this form is for you!


New Patient Forms

If you are new to Sitzmann Chiropractic, we ask that you complete all of the paperwork in this section, starting with our intake form

New Patient Intake and Triage

HIPAA Form

Medical History

Medicare ABN New Patient – This form is for Medicare patients only. If you have questions about the Medicare ABN policy please ask our receptionist.

All New Patient Forms – Find all above new patient forms here


Additional Forms:

Release Form of Medical Records – Use this form if we are going to receive a copy of your medical records from your current healthcare provider

Release Form of X Rays – Use this form if you need your X-Rays released to you

Automobile Accident Patient – If you have been in an accident, please fill out these necessary forms.

When faxing forms please use a cover letter and fax to: 864-458-8848 ATTN: Reception

When emailing forms please provide a contact number in case we need to reach you. Emails should be sent to: sitzchiro@bellsouth.net ATTN: Reception