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Online Forms

Dr. Tyra Beavers Chiropractic Health Center offers our patient form(s) online so they can be completed it in the convenience of your own home or 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 Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form


Motor Vehicle Accident New Patient Health History Form

We want to make sure we can accommodate your injuries to the best of our abilities.

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Workers Comp New Patient Health History Form

This lets us know the history and current state of your health due to an injury or series of injuries that occurred in your workplace. What questions, concerns, goals, regarding wellness can we help you with?

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 United HealthCare Optum New Patient Health History Form

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know! This form is very similar to the standard New Patient form however it has a couple extra pages required by United HealthCare.

Download & Print Form


Insurance New Patient Health History Form

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know! This form is almost identical to the standard New Patient form however it has a couple extra pages to help us further understand your insurance coverage.

Download & Print Form


Medicare New Patient Health History Form

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know! This form is almost identical to the standard New Patient form however it has a couple extra pages to help us further understand your Medicare coverage.

Download & Print Form



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