New Patient Paperwork

Name: Derrick Family Chiropractic & Massage
Address: 4525 Intelco Loop Southeast #Suite A, Lacey, Washington, 98503, United States
Telephone: 13604919135
Price range: $

Derrick Family Chiropractic & Massage offers our patient form(s) online so they can be completed in the convenience of your own home or office.

All forms are PDF files. You will need AdobeReader® to view them.
If you do not already have AdobeReader® installed on your computer,
Click Here to download.
Download the necessary form(s), print them out and fill in the required information.
Bring the necessary form(s) to your appointment.

Chiropractic- New Patient Form
Click to Download
Auto Accident - New Patient Form
Click to Download
HPPA and Terms of Acceptance
Click to Download
Terms of Acceptance
Click to Download

OFFICE HOURS

If you need emergency Chiropractic care or Massage Therapy please call our clinic for an immediate appointment.

Derrick Family Chiropractic & Massage

4525 Intelco Loop SE Suite A
Lacey, WA 98503
Chiropractic: (360) 491-9135
Massage: (360) 480-0191