Ragon Chiropractic Health Center offers our patient forms online so they can be completed in the convenience of your own home.
Please fill out both forms by clicking on the name of the form:
1. Patient Intake From - approximate time to complete: 15 - 20 minutes and submits electronically
2. Patient Systems Survey - approximate time to complete: 15 minutes and can be emailed to [email protected]. If email is not option, you are welcome to complete this form at our office prior to your appointment. If you prefer to use our HIPPA compliant text messaging, please send as a PDF or screen shot.
Please text us the following information to 330-537-6218:
3. Drivers License (Photo ID) and Insurance Cards (front & back)
4. Labs and Reports
Our text messaging is both secure and HIPPA compliant. Providing any of the above will help to shorten your check-in time at your first visit with us.