New Patient Information

Forms for New Patients

If you’re a new patient, print and complete these forms at your convenience and bring them along to your first appointment. These will give us a great head start on your care. Thank You.

Patient
Information

We’d like to know who you are and how to reach you.
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Case
History

We’d like to know your medical and chiropractic history. Knowing your past will help us treat you in the present... and the future.
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Authorized Representative

We’d like to work on your behalf to pursue insurance claims and other benefits.
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Terms of
Acceptance

We’d like permission to take care of you!
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Insurance

We are participating providers in most insurance networks in the state of Ohio. Questions? Call us at 419.425.9798 or email insurance@kirkchiro.com. Your plan may vary.

What to Expect

If you’ve never been to a doctor of chiropractic (DC), it’s natural to wonder what to expect on your first visit. To dispel any fears or uncertainties, we’ve prepared the following overview.

The Office

When you walk into a chiropractor’s office, it may very well look like the office of a medical doctor or a dentist. In some cases, however, your chiropractor may opt for a different look, one that’s warmer and less sterile. It all depends on his or her personal style and philosophy.
Your chiropractor or the office manager will greet you, take your name and ask you to fill out some forms and a questionnaire. That questionnaire will cover your medical background, family history and any previous treatment or surgery.

The Examination

When your DC is ready to see you, you will talk together in detail about the history of your complaint. He or she will also ask detailed questions about your health history. Chiropractors examine patients in much the same way that medical doctors do. Your chiropractor will test your reflexes and muscle strength. He or she may also take your temperature and your pulse. Range of motion is of particular interest to chiropractors, so expect a test to see how far certain joints in your body bend comfortably.
Your chiropractor may also order x-rays or use other techniques to complete or confirm a diagnosis. Be sure to ask questions about any procedures you aren’t familiar with.

The Care

If your DC finds a problem with joints in your spine, he or she may use adjustments to care for these joints. An adjustment is a quick but gentle pressure on a joint to loosen it. Chiropractors can perform adjustments either with their hands or with a mechanical device called an activator tool. (Doctors receive years of training to learn about manipulating bones in the back safely.)
Adjustments can produce a popping sound, similar to that of a cracking knuckle, when pressure in the joint is released. The sound is caused by bubbles of carbon dioxide gas escaping from the fluid surrounding the joints. The sound is harmless and the gas will eventually dissolve back into the fluid.
Adjustments shouldn’t be painful, although you may feel some discomfort until the pressure in the joint is relieved.

The Follow-Up

Depending on your condition, your chiropractor may schedule a series of visits for care. For example, he or she may want to see you three times a week for several weeks, then twice a week for two weeks and so on.
If so many visits seem unusual, consider this: when you see a medical doctor, he or she may prescribe pills to treat your condition. Because you can take the pills yourself, you don’t have to go back to the doctor’s office. Your chiropractor’s care, on the other hand, involves adjustments and tests that must be done in person.