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 Lifeline Chiropractic offers our patient forms online so you can complete them in the convenience of your own home or office. Download the necessary forms, print them out, and fill in the required information. Fax us your printed and completed forms or bring them with you to your appointment. Fax: (520) 745-8729.

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New Patient Health History Form (105a) - Required. This provides us with your past medical history and current state of your health.

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Functional Rating Index - Required for patients with neck and/or back symptoms. This measures your current level of spinal pain and function. 

6645 East 22nd Street

Tucson, Arizona 85710

For Life-Threatening Emergencies Call 911

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