The Vacaville Chiropractor to see - Chiropractor Vacaville

Online Paperwork

We offer our paperwork on line so you can complete it in the convenience of your own home. Here are the essential forms we use and why we need them.

Health History and Future

This let’s us know what’s happened, but perhaps more important, where do you want to take your health?

   New Patient Intake.pdf    Initial Intake Form                    

   Case History.pdf    Injury/Health History Form 

   Pain Assessment.pdf   Pain Assessment Form

   Download & Print Form    Initial Health Status Form for our ASH plan patients (ONLY).

Automobile Accident

If your health issue is the result of a car accident, we need some additional information.

  New Patient Intake.pdf

 Download & Print Accident History Form

 Download & Print Symptoms Form

Work or Other Injury

If your health issue is the effect of an injury at work, this information will help us help you.

  New Patient Intake.pdf

 Download & Print Form


Release of Records

If you have received chiropractic care elsewhere, or have medical records we will need from another practitioner, please sign this release.

 Download & Print Form

Free AdobeReader®

Each form is a PDF document file.  If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.



Dr. David Conner | 429 William St., Vacaville, CA | (707) 447-8100
Providing Quality Chiropractic Care to Vacaville
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Dr. David Asks some important questions of interest to Vacaville residents - Chiropractor Vacaville Dr. David Asks...

Why does chiropractic work?
Chiropractic works because your nervous system, consisting of your brain, spinal cord and all the nerves of your body, controls and regulates every cell, tissue, organ and system of your body. A chiropractor locates and reduces areas of nervous system compromise (usually along the spine) so your capacity to heal is restored. Chiropractic works by helping your body work as it was designed.
What's a side effect?
It may sound like a bonus; something extra, but chiropractors know it should more accurately called an "unintended effect," and "unwanted effect" or in some cases an "adverse effect." A pill can't come close to matching your body's ability to create and deliver the essential compounds it needs. That's when it's important to make sure your nervous system is working correctly—the purpose of chiropractic care!