For your convenience, Boutin Chiropractic provides our patient forms online to complete prior to your visit.

If you are unable to print and complete the forms before your appointment time, please arrive 15 minutes prior to your appointment time.

Download the necessary forms, print, and fill in the required information. If you do not already have AdobeReader® installed on your computer – Click Here to download.

Fax us (502-426-1337) your printed and completed forms or bring them with you to your appointment.

New Patient Intake Form

Patient Financial Agreement

Consent To Treat a Minor

HIPAA Consent Form

If you have any questions, please feel free to call our office (502-426-1330). We look forward to seeing you!

Find out how chiropractic care can get you started on the path to wellness.
Schedule An Appointment