Patient Forms


Butterfield Chiropractic offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic office.  

  1. Download the necessary form(s), print it out and fill in the required information. 

  2. Fax us your printed and completed form(s) to (425) 424-2127 or bring it with you to your first appointment.

 

New Patient

New Patient Intake
Notice of Patient Privacy Policy
No Surprises Act
 

Auto-Accident

Patient Intake (Auto)
Mechanism of Injury