Online Forms
Please fill out our online forms before your appointment to save time in our office.
Health History and Questionnaire
This lets us know what’s happened, but perhaps more important, where do you want to take your health?
HIPAA
Please read and sign our HIPAA form.
Car Accident Questionnaire
Please fill out if your condition is a result of a recent motor vehicle accident.
Free AdobeReader
Each form is a PDF document file. If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.
Take the First Step
Toward Relief Today
You don’t have to live with pain. At Perez Wellness Center, we’re ready to help you reclaim your health through comprehensive chiropractic care. Schedule your consultation today and start your journey to a pain-free, healthier life.