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Hurst Chiropractic offers our patient form(s) online so you can complete them 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 forms, print them out, and fill in the required information.
  • Fax us your printed and completed form(s) at 509-884-2363 or bring it with you to your appointment.
  • You can e-mail the completed form to frontdesk@hurstclinic.com

New Patient Forms - Required

HIPAA Notice of Privacy Practices

Download & Print Form

Acknowledgement of Receipt of HIPAA Privacy Practices

Download & Print Form

Informed Consent

Download & Print Form


Chiropractic Forms - Required

New Patient Case History

Download & Print Form

Functional Rating Index (Pain and Function Questionnaire - Required)

Download & Print Form


Pediatric Case History (New Patients 12yrs and under)

Download & Print Form


Update Patient Case History (Required after 3+ years lapse in care)

Download & Print Form


Optional New Patient Forms

Motor Vehicle Collision Questionnaire (Required for MVC Patients)

Download & Print Form

Spanish Case History

Download & Print Form


Massage Therapy Forms- Required

Massage Therapy Initial Intake

Download & Print Form

Massage Therapy Information and Policies

Download & Print Form


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THIS ---->https://hurstclinic.chiromatrixbase.com/online-forms.html

Office Hours

DayOpenClosed
Monday8:00am6:00pm
Tuesday8:00am6:00pm
Wednesday8:00am6:00pm
Thursday8:00am6:00pm
Friday8:00am6:00pm
SaturdayClosedClosed
SundayClosedClosed
Day Open Closed
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8:00am 8:00am 8:00am 8:00am 8:00am Closed Closed
6:00pm 6:00pm 6:00pm 6:00pm 6:00pm Closed Closed

Testimonial

Hurst Chiropractic has such an awesome staff! They have always been so good to me! Dr. Chad has been so helpful with the adjustments and even explaining stretches to help. Went there all through my pregnancy to help with my back pain and now I am taking my son there as well. They do great with children! Highly recommended!

- Sarah P.
East Wenatchee, WA

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