New Patient Paperwork

Platinum Chiropractic offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • 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.
  • Download the necessary form(s), print them out and fill in the required information.
  • Bring the necessary form(s) to your appointment.
  • Adult – Health Record and Authorization

    Click to Download

  • Child – Health Record and Authorization

    Click to Download

Monday
7:30am - 1:00pm
3:00pm - 6:00pm


Tuesday
2:00pm - 6:00pm


Wednesday
7:30am - 1:00pm
3:00pm - 6:00pm


Thursday
2:00pm - 6:00pm


Friday
Closed


Saturday & Sunday
Closed

Platinum Chiropractic

4172 Lake Michigan Dr NW
Grand Rapids, MI 49534

(616) 419-4996