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Advanced Spinal Health, LLC. offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic 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 (661.327.0614) your printed and completed form(s) or bring it with you to your appointment.

Chiropractic New Patient Health History Form - 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!

Dr. Salyers Chiropractic New Patient Form
Dr. Heyart Chiropractic New Patient Form

Chiropractic Additional New Patient Forms - Required

Consent for Chiropractic Care
Health Information HIPPA
Insurance Billing Form
Office Policies


Nutritional Consulting New Patient Forms - Required

Dr. Salyers Nutritional Intake Form
Metabolic Assessment Form


Need Directions to Our Office?

Map & Directions


Member Wellness Registration Form 

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our chiropractic office.  Click Here to register online! The online newsletter sign-up is also in the optional area. We look forward to making your experience with our office and website more interactive and rewarding!



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