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Online Forms

North County Integrative Health Center offers our patient form(s) online so you can complete it 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.

  • New Patient Health History Form - Required

    As you will soon learn, wellness chiropractic care can have global effects on the rest of your bodily functions. Many of our patients come in for neck pain or back pain, and once their nervous system is functioning better, many symptoms like fatigue, heartburn, anxiety, and digestion improve (the list goes on). Thank you for the honor of working with you on your path to optimal health.

    Please let us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know! Please fill out the following New Patient Forms to your best ability prior to your first appointment. If you have any questions we will be more than happy to answer them when you arrive for your visit.

    Form 1

    Download & Print Form


    New Patient Nutritional and Lifestyle Education Consultation Forms:

    Lifestyle Education is very comprehensive. It includes: how you eat, how you sleep, what type of exercise you do, how much water you drink, and more. These forms will give Janice a broader view of how you currently live your life and how she can help you reach your health and wellness goals. Please fill out the following forms to your best ability prior to your first appointment.

    Health History

    Download & Print Form

    Diet Diary and Exercise Log

    (please fill out as accurately as possible 1 week prior to coming in for your initial consultation)

    Download & Print Form


    Download the Free AdobeReader®

    SIGN-UP USING THE FORM OR CALL US AT 760-753-0700

    Location

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    Office Hours

    Our Regular Schedule

    Monday:

    8:30 AM

    5:00 PM

    Tuesday:

    CLOSED

    CLOSED

    Wednesday:

    8:30 AM

    2:00 PM

    Thursday:

    1:00 PM

    7:00 PM

    Friday:

    8:30 AM

    2:00 PM

    Saturday:

    Appointment

    Only

    Sunday:

    CLOSED

    CLOSED