Harcourt Chiropractic, York, PA

New Patient Forms

Saving time on your first visit is as easy as 1, 2, 3. You may download the following new patient forms and complete them at your leisure prior to your arrival. Please let our staff know you will have this paper work completed when you come in so they can schedule accordingly.

Note: Acrobat reader is required to open these files. If you do not have Acrobat reader you may download it from this site.

#1 All new patients need to complete these 4 pages: Patient Information Form

#2 If you where in an Automobile Accident complete this form as well as #1

#3 If you were hurt on the job and this is a Work Injury claim please complete this form as well: Work Injury Form