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Online Forms

Back to Balance Chiropractic offers our patient form(s) online so they can be completed 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.

Please be advised that there will be one additional page of paperwork to be completed and signed regarding medical privacy laws. If you have any questions or concerns about the information presented in the paperwork, do not hesitate to give us a call at (559) 783-2225.


New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know! 

Print Form


Pediatric Health History Form

This form is for children aged 0 to 5 years.

Print Form


Children's Health History Form

These forms are for children aged 6 to 11 years.

Print Form



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CONTACT US TODAY

We look forward to hearing from you

Office Hours

Our Regular Schedule

Back to Balance Chiropractic

Monday:

8:30 am-12:00 pm

1:30 pm-5:00 pm

Tuesday:

1:00 pm-5:00 pm

Wednesday:

8:30 am-12:00 pm

1:30 pm-5:00 pm

Thursday:

1:00 pm-5:00 pm

Friday:

8:30 am-12:00 pm

Saturday:

Closed

Sunday:

Closed

Locations

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Testimonials

Reviews By Our Satisfied Patients

  • "After having had chiropractic adjustments for 60 years, I feel Dr. Bush was heaven sent to me. I am amazed at the fast results I have made in a short time. I am so much better that I now feel like I am back among the living."
    Betty P.
  • "After several months of seeing Dr. Bush and feeling much better, I asked if I could check my weight I was so astonished that the scales revealed a 1 lb difference of distribution of my weight."
    Bob O.
  • "Dr. Bush has helped me so much and I recommend her to everyone I talk to with any of the symptoms I had."
    Margaret C.
  • "I crawl in, walk out! Don't think I could function without her! Great staff too!"
    Roxy M.
  • "Quality care."
    Amber R.
  • "Chiropractic care helps keep my body in alignment & pain-free."
    Angela B.
  • "Awesome office staff! Dr. Bush is phenomenal- really treats your overall well being!"
    Vikki C.
  • "Very compassionate to me when I am in pain. Very helpful and answers my questions."
    Beverly F.

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