Health History

We offer our paperwork on line so you can complete it in the convenience of your own home. Here are the essential forms we use and why we need them.


Patient Intake

This let’s us know what’s happened, but perhaps more important, where do you want to take your health?
 Download & Print Form

If you are experience Back Pain, please complete and include this Back Index.
 Download & Print Form

If you are experience Neck Pain, please complete and include this Neck Index.
 Download & Print Form


Free AdobeReader®

Each form is a PDF document file.  If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.

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Dr. Jim Asks some important questions of interest to Phillipsburg residents - Chiropractor Phillipsburg Dr. Jim Asks...

What does a chiropractic adjustment do?
Chiropractic adjustments give your spine a little "nudge" at the right place, right time and the right direction so your body can use that energy to "right" itself. With a schedule of consistent chiropractic visits, a new, healthier spinal pattern emerges.
Is chiropractic safe?
What do you consider safe? Chiropractic care is safer than driving your car on the streets of Phillipsburg, getting back surgery, taking aspirin and even safer than taking a shower in your own home! Compared with things we accept as safe, chiropractic care is even safer. Ready to get started? Call our office today.