Becoming a New Patient of Dr. Girard's: Patient Intake Forms and More.

Welcome!  All new patients are required to fill out the "Patient Intake" form and a "Consent to Treatment" Form. 

This gives us the necessary information to :

  • Process you as a new patient

  • Address your chiropractic and health issues

  • Assess your health  problems related to your structural issues

  • Assist you with insurance claims

 

You may come to office and fill out forms there. If so, 

please  sure to get there 20 minutes before you meet with the doctor.

If you wish to avoid coming in 20 minutes before your appointment, you may download these forms and fill them out.

 

Dr. Girard asks these questions so that she may have a better understanding about your health issues. Be as thorough as possible.

 

Be sure to fill out all sides of the forms so that the doctor may spend all the appointment time assessing and administering treatment.

Please sign  and date both forms. . These are required of all patients before they can be treated.

We look forward to seeing you in our office and giving the best care possible.

Dr. Valerie Girard

Chiropractic Care, Cold Laser Therapy, Nutritional & Functional Medicine

1725 State Street B

Santa Barbara, CA 93101

805-687-1617 Office

805-682-1365 fax

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