Two Convenient Locations

  • ● 23116 Cinco Ranch Blvd. Katy, TX 77494
  • ● 19227 Katy Fwy. Suite 100, Houston, TX 77094
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Call Us Today

(281) 347-4444
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Exclusive Offer

Exclusive Offer, New Patients receive Free Consultation.

Katy Lifestyle 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.


Chiropractic Forms

New Chiro Patient Intake Form - Required

This online form can be completed on a computer or an iPAD. (Sorry - Online forms cannot be completed on mobile devices, or Android devices).

IMPORTANT:  PLEASE READ CAREFULLY BEFORE FILLING OUT ONLINE FORM:  We ask that you be VERY detailed when filling out the forms.  You will answer questions on your PRIMARY AREA OF COMPLAINT first.  If there are additional areas of complaint, you will indicate that when you complete the questions for the primary complaint.  You will be able to share up to 4 areas of complaint.  When done, electronically sign the form and click SUBMIT to upload forms to our office.

Due to federal law, once submitted, the form cannot be modified.  We ask that forms be completed one day prior to your appointment so the doctor has time to review them before your arrive.   

If you are unable to complete the form at home, please arrive 20 minutes early for your appointment.  

Transfer of Medical Records Form - Optional  

If you wish to transfer medical records, X-Rays or other scans to our office, please download and complete the following release form on paper.  You can bring the form into our office or fax it to us.  

Click here for Authorization for Medical Records Release


Nutrition Forms

Food Diary

Download & Print Form

The Page Fundamental Diet Plan

Download

Cannot open the forms?  If you do not already have AdobeReader® installed on your computer, Click Here to download.

Featured Services

Services
We strive to provide complete care for our patients. Learn more about all the services we provide.
Make An Appointment
We will do our best to accommodate your busy schedule. Schedule an appointment today!
Online Forms
Our patient forms are available online so they can be completed in the convenience of your own home or office.