Download Your New Patient Forms Before Your Visit
At Avalon Chiropractic Healing Center, we make it easy to get started by offering downloadable patient forms you can complete from home. Simply print, fill out, and bring your forms to your first appointment — or fax them to our office in advance. This helps streamline your check-in and ensures we can dedicate more of your appointment time to your care. Call us at (760) 340-1264 - Palm Desert Office or (909) 921-8415 - Rancho Cucamonga Office if you have any questions before your visit.
Patient Forms Available for Download
Completing your paperwork ahead of time is one of the best ways to make your first visit at Avalon Chiropractic Healing Center as efficient and comfortable as possible. Our new patient form covers your health history, current symptoms, family medical background, and insurance information — everything our doctors need to develop an accurate and effective treatment plan for you.
New Patient Form: Download & Print Form (PDF)
If you do not have Adobe Reader® installed on your computer, you can click here to download it for free.
Once completed, you can fax your forms directly to our office or bring them in at the time of your appointment. If you prefer to fill out paperwork when you arrive, our friendly front desk staff will be happy to assist you. We recommend arriving 10–15 minutes early to allow time for this.
Why We Collect This Information
The information you provide in our intake forms allows Dr. Jua E. Pak, DC, and Dr. Andrew Lind, DC & ESQ to better understand your health history and current condition before your first evaluation. This includes details about any prior injuries, surgeries, medications, and lifestyle factors that may be contributing to your pain or health concerns. The more complete your forms are, the more personalized your care will be from day one.
Not sure what to expect at your first appointment? Visit our Your First Visit page for a full overview of what happens when you walk through our doors. You can also learn more about what to expect during your chiropractic visit at Avalon Chiropractic Healing Center. For questions about coverage and costs, review our Payment Options page or call our Palm Desert & Rancho Cucamonga office at (760) 340-1264 - Palm Desert Office or (909) 921-8415 - Rancho Cucamonga Office .
Online Forms FAQs
Can I fill out my new patient forms online instead of printing them?
Currently, our new patient forms are available as a downloadable PDF that you can print and complete at home. We recommend printing them in advance to save time at your appointment. If you have trouble accessing the PDF, please call our office at (760) 340-1264 - Palm Desert Office or (909) 921-8415 - Rancho Cucamonga Office and our team will assist you.
Do I need to complete paperwork before my first chiropractic visit?
While completing forms in advance is not required, it is strongly encouraged. Having your intake forms completed before your appointment allows our doctors at Avalon Chiropractic Healing Center to review your health history prior to your evaluation, which helps make your first visit more focused and productive.
What information is included in the new patient form?
Our new patient form asks for basic personal and contact information, insurance details, your current health complaints, medical history, family health history, and lifestyle habits. This comprehensive overview helps our doctors create a treatment plan specifically tailored to your needs from the very first visit.
Can I fax my completed forms to your office?
Yes. Once you have completed your printed forms, you are welcome to fax them to our office prior to your appointment. Alternatively, you can bring them with you in person. If you need our fax number or have any questions, please contact us at (760) 340-1264 - Palm Desert Office or (909) 921-8415 - Rancho Cucamonga Office .
What if I need help completing my patient forms?
Our front desk team is always happy to help. If you arrive without completed forms or need assistance filling them out, simply come in a few minutes early and our staff will walk you through the process. You can also call (760) 340-1264 - Palm Desert Office or (909) 921-8415 - Rancho Cucamonga Office in advance and we’ll answer any questions you have about the forms.
Are there separate forms for different types of patients or conditions?
At this time, we use a general new patient form that covers all conditions and services we offer, including chiropractic care, holistic medicine, functional medicine, and auto accident injury treatment. If additional documentation is needed for your specific situation, our team will let you know at the time of scheduling.
How do I schedule my first appointment after submitting my forms?
You can schedule your appointment by calling our Palm Desert or Rancho Cucamonga office at (760) 340-1264 - Palm Desert Office or (909) 921-8415 - Rancho Cucamonga Office , or by requesting an appointment online. After your forms are submitted, our team will confirm your appointment time and let you know what to bring on your first day.