Doctor's Office Intake Forms

This is what iConnect Family Chiropractic was looking for in their word template design

Hi,

I am looking to have the following form to be replicated and combined with the other files. I do not want this form merely digitized but a new form to be created but asking the same questions with our logo etc. Please add a section for allergies and medications taken. For the Sexually transmitted infections the choices are the ones listed plus Pelvic Inflammatory Disease, Syphilis, HIV, and Hepatitis.

Please use common sense. The example file provided is a print out of a digital intake form. Read more