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650-588-9962 H
H

650-588-9962

Patient Forms

Congratulations! You've taken the first exciting steps toward the recovery of your health - your most valuable possession!

Desmarais Chiropractic offers our new patient forms online so they can be completed it in the comfort of your own home or office.  Please have forms completed upon arrival for your first visit.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary forms, print them out and fill in the required information.
  • Fax us your printed and completed forms to (650) 588-9964 or bring them with you to your first appointment.

---  OR ---

  • Below is the link for the new patient forms to be filled out online. Just submit ​and we will receive your information electronically. Unfortunately, the forms are not mobile friendly, please use a desktop or laptop computer. 


 

New Patient Health History Forms - 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!

New Patient Intake Forms - For All Patients
Download & Print Forms

Additional New Patient Health History Form for Automobile Accidents Only
Download & Print Forms

This form asks more specific questions about your automobile accident. 
 

Just a quick note to thank you for selecting our office and to let you know how much we are all looking forward to helping you!

Exclusive Offer

Now accepting new patients!

Sign-up using the form or call us at 650-588-9962 to take advantage of this exclusive offer.

Office Hours

Day
Monday9:00 - 12:003:00 - 6:00
Tuesday9:00 - 12:00Closed
Wednesday9:00 - 12:003:00 - 6:00
ThursdayClosed3:00 - 6:00
Friday9:00 - 11:00Closed
SaturdayClosedClosed
SundayClosedClosed
Day
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
9:00 - 12:00 9:00 - 12:00 9:00 - 12:00 Closed 9:00 - 11:00 Closed Closed
3:00 - 6:00 Closed 3:00 - 6:00 3:00 - 6:00 Closed Closed Closed