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Niu Health for a New You! at Niu Health 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.

  • Fill in the required information. Make sure to click Submit at the end of your form!

New Patient Forms! 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! Your privacy is important to us. The web forms are safe and secure.

New Patient Health History Form - Required

Informed Consent and Arbitration Form - Required to read and, if in agreement, please initial the relevant boxes at the end of your New Patient Health History Form (included in form listed above).

 

HIPAA Notice of Privacy Practices - Required to review. Please initial that you have reviewed this notice at the end of your New Patient Health History Form.

New Reiki Client Information and Consent Form - For existing patients.

Financial Hardship Form - For those whose household income is below 200% of Hawaii's Poverty Guidelines.

Download & Print Request for Medical Records Form - (optional) To request release of medical records to Niu Health Chiropractic. 

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