New Patient Paperwork

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

  • HIPPA and Terms of Acceptance

    Click to Download

  • Terms of Acceptance

    Click to Download

OFFICE HOURS


Monday
8:00am - 6:00pm


Tuesday
8:00am - 4:30pm


Wednesday
8:00am - 6:00pm


Thursday
By Appointment Only


Friday
8:00am - 6:00pm


Saturday
8:00am - 11:00am


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

Chiropractic Lacey WA Derrick Family Chiropractic & Massage

Derrick Family Chiropractic & Massage

4525 Intelco Loop SE Suite A
Lacey, WA 98503

(360) 491-9135
Texting Available!