New Patient Forms

At Lowey Chiropractic Wellness Center, we offer our patient forms online so you can complete them in the privacy and convenience of your own home or office.  If you need assistance with any of the forms, please contact us.\

The following 3 forms need to be filled out prior to your initial visit.  Please click on the necessary form, print it out and fill in the required information.
You can either bring them with you to your first visit or fax us your printed and completed forms (508-255-0888 fax).

On the Case History form we will require your initials to verify that you read and understand the Office Policy, Financial Policy, Informed Consent, and Privacy Policy information.   You can read them here, then just initial the confirmation area on the last page of the case history.


If you would like to read over our office policies, they are offered below for your convenience.

Outline of Services and Procedures for New Patients

Step 1- Health History Questionnaire 
All new patients are requested to fill out a personal health history questionnaire. Forms are available at our office on your first visit.They can also be accessed, for your convenience, at 

Step 2- Consultation 
We will have a consultation to discuss your health objectives. 

Step 3- Examination and Diagnostic Tests 
Chiropractic tests will be performed to detect any irregularities in your nerve, muscle and skeletal systems. Computerized Surface EMG, X-rays and other additional procedures may be performed as well. 

Step 4- Report of Findings 
The report of findings will be a time for the doctor to go over your examination and test results.  Your recommended health care program will be explained to you (please bring your spouse or partner to this report of findings).  You will be advised about financial arrangements and insurance coverage if appropriate.  Any questions regarding your care program may be addressed at this time. 

Step 5- Chiropractic Care 
Your chiropractic care will continue with scheduled adjustments to correct any subluxations detected during the examination.  

Step 6- Total Health Scan (Brimhall - 6 Steps to Wellness) 
This is a kinesiology scan which is vital so that we can detect any of the six (6) interferences which may impede your full recovery.   

Step 7- Re-examination 
A re-examination will be performed to measure your progress and improvement.  During the same visit we will re-do your EMG scan to be able to compare with the one done on your initial visit.   

Step 8- Progress Report 
At this time we assess how your health has improved with chiropractic, and make recommendations for your ongoing care.