Online Forms

Verification of Insurance is NOT a guarantee of benefits

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

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

Acupuncture Chiropractic Intake Form

Download & Print Form


Hypnotherapy/Coaching Intake Form

Download & Print Form Part 1

Download & Print Form Part 2


Auto Accident Intake Form

Download & Print Form


Consent Form

Download & Print Form


Consent to Treat a Minor Form

Download & Print Form


Office Policies

Download & Print Form


Facial Acupuncture Intake Form

Download & Print Form


ASH ACU Patient Progress Form

Download & Print Form


ASH CHIRO Initial Health History

Download & Print Form


ASH CHIRO Patient Progress Form

Download & Print Form


Chiro Initial Intake Health History

Download & Print Form


DASH Disability Arm Shoulder Hand

Download & Print Form


Headache Disability Form

Download & Print Form


Low Back Roland Morris Disability Questionnaire

Download & Print Form


Oswestry Low Back Pain Scale

Download & Print Form


Oswestry Neck Form

Download & Print Form


Symptom Diagram Form

Download & Print Form



Download the Free AdobeReader®

Hours

Mon

9:00 am - 6:00 pm

Tue

By Appointment

Wed

9:00 am - 6:00 pm

Thu

By Appointment

Fri

9:00 am - 2:00 pm

Sat

By Appointment

Sunday

Closed

Mon
9:00 am - 6:00 pm
Tue
By Appointment
Wed
9:00 am - 6:00 pm
Thu
By Appointment
Fri
9:00 am - 2:00 pm
Sat
By Appointment
Sunday
Closed