Patient Paperwork

Welcome to our family of patients and friends

Chiropractic Care of Marietta Square offers our patient forms online to expedite your evaluation and treatment time with Dr. Trent Brumbaugh.  Please download, complete and returnthe following forms in advance of your appointment with us:

NEW PATIENT FORMS

All forms are PDF files. You will need AdobeReader® to view them.  If you do not already have AdobeReader® installed on your computer, Click Here to download.

Consent Form

Patient Information Form

Medical History Form

Insurance Form

You may fax your completed forms to us at 770-428-4956 or by emailing:  forms@drtrentchiro.com