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Exclusive Offer

New Patients Receive a Free Consultation

Online Forms

Gran Miracle Chiropractic offers our patient forms online, allowing you the opportunity to complete them from the convenience of your own home or office!  

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

Required Forms

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 Health History

Health Questionnaire 

Consent to Treat Statement (HIPAA)

Information Disclosure Agreement (HIPAA)


All forms open to a new window.


Additional Forms

Car Accident

Patient Information Update



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