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(860) 388-1654

New Patient Forms

Connaughty Chiropractic offers our patient form(s) online so you can complete it in 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.

New Patient Health History Form – Required

This let’s us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form

Instructions For Completing the New Patient Health History Form

Download form via the link above. You can click in the form to type in your information and select check boxes where applicable. PLEASE NOTE: You cannot save a completed copy of this form on your computer. If you would like a copy for your records, please fill it in and print it.