Welcome to the Agape Chiropractic new patient center!

We want your first visit to be AWESOME! Our new patient center can help you prepare ahead of time. Here you'll find everything from downloadable new patient forms to what you can expect on your first visit. Feel free to download your paperwork here and fill in out in the comfort of your own home or office. Then, just bring it with you on your first visit.

Download the necessary forms (.pdf), print them out and fill in the required information.

New Patient Packages

The forms should be printed and filled in completely prior to coming in for your first visit. Do not attempt to fill in the forms electronically. Use the link that best applies to your status. To view our Privacy Practices, click here.

1. Patients involved in litigation pertaining to an injury for which they are seeking care, please complete this package (this is for patients that are seeking care in which the at-fault party will be responsible for health care bills):
Litigation Patient Package

2. Patients injured in an Automobile Accident, please complete this package (this is usually for patients that were at fault in an automobile accident that will be responsible for their co-payment and deductible)::
Non-Litigation Automobile Accident Package

3. Patients using their Health Insurance, please complete this package (this is usually the regular health care insurance or PPO policy holder):
Health Insurance Package

4. All other patients, please complete this package (this is the easiest package and is usually for the self paying patients):
Most Patients

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