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New Patient Forms

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

To help expedite your first visit, please download the necessary form(s) listed below, print form and fill in the required information. Please bring the completed form(s) with you to your first appointment, along with your insurance card and drivers' license. If you have any questions, feel free to contact us.

If you do not already have AdobeReader® installed on your computer, Click Here to download. 

New Patient Health History: This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? 

Download & Print Form

HMO Insurance - Initial Health Status: If you have HMO insurance, please fill out this form in addition to the pages above for us to process your care. 

Download & Print Form

Automobile Accident: If your health issue is the result of an auto accident, we need some additional information. Please fill out this form in addition to the health history form above.

Download & Print Form

Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form

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Dr. Judd Lowrey | Lowrey Chiropractic  
El Dorado Hills Chiropractor | (916) 941-7508 
4909 Golden Foothill Parkway, El Dorado Hills, CA 95762