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Online Forms

Lakeshore Family Chiropractic offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic office.


    New Patient Health History Form - Required

    This form lets us know your history and your current state of your health. As you complete the form, if you should have any questions, concerns, or goals regarding your health and wellness, please write them down and we will address them at your appointment.

    • 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.

    Download & Print Form

    Member Wellness Registration Form - Optional

    This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our chiropractic office. You can print the form out and bring it in to our office during your next visit with our chiropractor, or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

    Download & Print Form


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    Tue 8 - 12
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    Wed 8 - 12 2 - 6
    Thu Closed 2 -6
    Fri 8 - 12 2 - 6

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    Lakeshore Family Chiropractic
    244 W. James Street, Suite B
    Holland, MI 49424
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    • Phone: 616-396-6635
    • Fax: 616-396-6679
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