New Patient Forms
We are excited that you have chosen us for your medical care and look forward to meeting you. The New Patient Form is a form that you can fill out and submit online for your convenience. You can also save some time by printing out and completing the other forms in advance of your appointment so we can expedite your visit. If possible, please fax them to 281-332-7593.
3. Notice of Privacy Practices: HIPAA form
4. At least one of the following Pain Indexes. If you are not sure what forms you need please call the office and we will be more than happy to help you or you can wait until you get to the office before filling out the pain indexes. If you have multiple problems please fill out more than one index.
For those patients scheduled for a nutrition examination please fill out our Nutrition Policy PRIOR to your appointment. Please note, nutrition exams must be scheduled specially by our team and can not be worked into a regular appointment.
James Heintz, DC, CCSP
Brian Sansalone, DC, CCSP
Tanner Brusnighan, DC
League City Chiropractic
1200 East Main Street
League City, TX 77573