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Lighthouse Family Chiropractic offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic 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 completed form(s) to (614) 876-0996 or bring them with you to your appointment.

New Patient Health History 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!

NOTE: ONLINE SUBMISSION WILL ONLY WORK FROM A COMPUTER OR IPAD;

PLEASE DON'T USE A PHONE TO COMPLETE.

ONLINE PATIENT INTAKE FORM


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our chiropractic office. You can print the form out and bring it in to our office during your next visit, or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form



Download the Free AdobeReader®

Welcome to Lighthouse Family Chiropractic!

THIS ---->https://lighthousefamilychiropractic.com/online-forms.html

Office Hours

DayMorningAfternoon
Monday9am6pm *
Tuesday12pm4pm
Wednesday9am6pm *
Thursday12pm4pm
Friday9am6pm *
SaturdayBy Appt.
SundayClosedClosed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
9am 12pm 9am 12pm 9am By Appt. Closed
6pm * 4pm 6pm * 4pm 6pm * Closed

*Closed MWF between 1 p.m. and 3 p.m.

Testimonials

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