Pediatric Patient Paperwork

Pediatric Patient Paperwork

Smiley Family Chiropractic 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 or browser, 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.

Pediatric Patient Intake Form

HIPAA Notice

Financial Policy

Consent Form

Kids taking a selfie sitting outdoors