Online Forms

Kirk Chiropractic 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 Adult 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


Pediatric Patients (13 yo & under) Health History forms

Download & Print Form


New Patient Automobile Accident Questionnaire
Required for your first visit (if you are seeking treatment for an auto accident)

Download & Print Form


HIPAA Notice of Privacy Practices

Download & Print Form


Download the Free AdobeReader®

Sign up using the form or call 918-272-6200 to make your appointment. Please do not leave solicitation messages on this page.

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Testimonial

  • "After 10 years and three chiropractors who couldn't or didn't really care, I finally found Dr Kirk and his team. Together they healed my back pain and restored my faith in their profession. Within thirty minutes i found out why I was hurting and within twenty four hours Dr. Kirk had a plan on how to make me better. I cant thank you all enough. I'm doing things I thought I would never be able to do again. I am eternally grateful. If you need help, give them a call, and you will actually get the, respect, concern, and care you need."
    Dusty C. / Owasso, OK

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