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Valley Center Chiropractor | Valley Center chiropractic care | CA | Patient Forms

Valley Center Chiropractic

& Holistic Care

Voted Best Chiropractor in San Diego

Affordable All Natural Health Care for the Whole Family 

(760) 500-6253

Patient Forms

Valley Center Chiropractic offers patient forms online so they can be completed 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) at 1-760-751-3559, or bring it with you to your appointment.
  • If you cannot print out your forms, come in 30 minutes early to do so.


Before your visit, please verify your insurance coverage for chiropractic care. I am "in network" for all major insurance companies and Medicare as a "participating provider". I do not accept Medical.

Please determine your remaining deductible, if any, and your co-pays, by calling member services on the back of your card.

Kaiser patients, I will determine if you have coverage. Many of you do unbeknowst you! Being "in network" for Kaiser, you are automatically eligble for my sliding scale fees for chiropractic.

New Patient Orientation- Required reading before your appointment.

If you desire chiropractic care and are new to chiropractic , please read What is Chiropractic?

If you desire natural medicine and nutritional care and are new to alternative medicine and applied kinesiology (muscle testing) please read What is Nutrition Response Testing and Designed Clinical Nutrition?

New Patient Health History, Policy and Consent Forms - All five required

Download and print out the following forms, complete them fully, and bring them in to our office or FAX to 1-760-749-9069. If you cannot complete these forms before your visit, we need you to arrive 45 minutes early to allow time to do so.

Form #1: New Patient Introduction

Form #2- New Patient Presenting Complaints and History

Form #3 - Metabolic Assessment

Form #4 - Office and Insurance Policy

Form #5 - Consent Forms

(Dr. Maher will witness the patient consent forms with you and answer any questions related to consent that you wish to discuss).   

READ  Privacy Policy  : Your Health Information Privacy Rights

We invite you to visit and like us at www.facebook.com/valleycenterchiropractic 

I promise you frequent informative posts, news, events and workshop announcements

and self help advice for you and your friends!

Valley Center Chiropractor | Patient Forms. Dr. John Maher, D.C. is a Valley Center Chiropractor.