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Fernley 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.

  • 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.


New Patient Intake Forms


It is important to print out these forms, fill them out and bring them in to your appointment. You will not be able to fill them out online and email them in.

Welcome Brochure
Intake Form
Advanced Beneficiary Notice
HIPPAA Form
Auto Accident Questionaire



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


Download the Free AdobeReader®

Exclusive Offer

FREE jar (1lb) of raw local honey when you like us on Facebook!

Sign-up using the form or call us at 775-575-5511 to take advantage of this exclusive offer.


American chiropractic association

THIS ---->https://my.chiromatrixbase.com/fernleychiro.com/online-forms.html

Office Hours

DayMorningAfternoon
Monday9:00 - 12:302:00 - 6:00
Tuesday8:00 - 12:001:30 - 5:00
Wednesday9:00 - 12:302:00 - 6:00
ThursdayClosedClosed
Friday8:00 - 12:001:30 - 5:00
SaturdayClosedClosed
SundayClosedClosed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
9:00 - 12:30 8:00 - 12:00 9:00 - 12:30 Closed 8:00 - 12:00 Closed Closed
2:00 - 6:00 1:30 - 5:00 2:00 - 6:00 Closed 1:30 - 5:00 Closed Closed

Testimonial

The experience I had at Fernley Chiropractic has been fantastic! Dr. Kahn has always taken the time to evaluate my needs and provide the proper care. I highly recommend Fernley Chiropractic to all my friends and family!

Shauna D.s
Fernley, NV
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