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Online Paperwork

We offer our paperwork on line so you can complete it in the convenience of your own home.


Medical Insurance or Cash Patients

This let’s us know what’s happened, but perhaps more important, where do you want to take your health?

Download & Print Form


Automobile Accident

If your health issue is the result of a car accident, we need some additional information.

Download & Print Form


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.

If you have any questions, please click the “Email Doctor” button at the bottom of each page or call Lifestyle Chiropractic & Fitness Center at (925) 978-2225 to reach one of our staff. We look forward to assisting you with anything you may need!