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206-527-0123 H
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206-527-0123

Online Forms

Ultra Chiropractic offers our patient form(s) online so you can complete 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 Forms (Required)

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


New Patient Form

These forms are for NEW CHIROPRACTIC PATIENTS. Please download and print these forms. If you would like to complete these forms before you come to your appointment it can help save time.

Download & Print


Massage Intake

These forms are for NEW MASSAGE PATIENTS. Please download and print these forms. If you would like to complete these forms before you come to your appointment it can help save time.

Download & Print


Motor Vehicle Collision Questionnaire

These forms are for if you are seeking care in our office for injuries related to a motor vehicle collision.

Download & Print


Labor and Industries Questionnaire

These forms are for if you are seeking care in our office for on-the-job injuries, through Labor and Industries.

Download & Print


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 office. You can print it out and bring it in to our office 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

New Patients Receive a Free Consultation.

Office Hours

Day
Monday9am - 12:30pm2pm - 6:30pm
Tuesday2pm - 6:30pm
Wednesday9am - 12:30pm2pm - 6:30pm
Thursday2pm - 6:30pm
Friday9am - 12:30pm2pm - 6:30pm
SaturdayMassage OnlyMassage Only
Sunday
Day
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
9am - 12:30pm 9am - 12:30pm 9am - 12:30pm Massage Only
2pm - 6:30pm 2pm - 6:30pm 2pm - 6:30pm 2pm - 6:30pm 2pm - 6:30pm Massage Only