SYLVAN CHIROPRACTIC CLINIC AND WELLNESS CENTER

5440 SW Westgate Drive

Suite 100

Portland, Oregon 97221

 

P: 503.297.4447

 

F: 503.296.8414

Call now, and let us help you today!

 

Seth Alley,DC,CCSP®,CKTP

Clinic Owner

Leah Bowder,LMT

Alexia Sloan,L.Ac.






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New Patient Forms

We know that paperwork in a doctor's office can be tedious and time-consuming to complete. But the information you provide helps give us an accurate picture of your current health and the conditions you are experiencing that need treatment. Below you will find the documents for new patients to be completed prior to your first visit. Depending on which practitioner you are seeing in our clinic, please download the correct forms and bring them with you to your first appointment.


You will need the most recent version of Adobe Reader to download and read these files. If you do not have Adobe Reader installed, you can download the most recent version by clicking on this link: 


Chiropractic Patients

In order to make your first visit to our office easier for you, please download the following NEW PATIENT INFORMATION PACKET and complete EACH of the forms at your convenience. Be sure to bring the completed forms with you to your first appointment, with any previous test results, x-rays, or health documents that you have and feel are important. The documents titled "Insurance Coverage and Patient Liability Policy" and "Notice of Privacy Practices" are for your own records and do not need to be returned to the office. 

If for some reason you are not able to download these forms, please plan on coming in fifteen to twenty minutes prior to your scheduled appointment time to complete the paperwork in our clinic. In addition, please bring a recent copy of your health insurance card and a current photo ID if you plan to have our office bill your insurance company for your care.

If you have recently been in a motor vehicle collision, you are required to complete the following intake form in addition to the New Patient Information Packet prior to being seen and treated at our clinic:

If you have recently been injured in a work-related accident, you are required to complete the following intake form in addition to the New Patient Intake Information Packet prior to being seen and treated at our clinic:

Food Intolerance Testing Patients

For those patients who are coming to the clinic for food intolerance (sensitivity/allergy) testing, please download and complete the Food Intolerance Testing Packet prior to being seen and treated at our clinic:

Massage Therapy Patients

Please download and complete the following new patient intake form:

 

Sylvan Chiropractic Clinic and Wellness Center, LLC provides health care and chiropractic care to patients suffering from auto accident injuries, sports injuries, arthritis pain, back injuries and lower back pain, carpal tunnel syndrome, degenerative disc disease, herniated disks, fibromyalgia, elbow and knee joint pain, migraine headaches, neck pain, sciatica, scoliosis, shoulder pain, whiplash, food sensitvity and more. Based in Oregon, Sylvan Chiropractic Clinic and Wellness Center, LLC serves patients from Portland, Beaverton, Hillsboro, Tigard, Aloha, Forest Grove and throughout Washington County and the Portland metro area.