At the office of Dr. Kelly Lucas, we offer patient forms online so you can complete them in the convenience of your own home or office. Fax us your printed and completed forms or you may bring them during your visit.

New Patient Health History 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!

Download & Print Forms
Spanish Forms


ASHP Initial Health Status Forms
If your Insurance Company goes through American Specialty Health for your Chiropractic benefits they required that you fill out this form. If you’re not sure if your Insurance Company goes through ASHP you can call your Insurance Company directly or you can call us and we can help find out for you. Most Insurance Companies that go through ASHP consist of but not limited to Blue Cross HMO, Blue Shield HMO, Cigna HMO & POS, Health Net HMO, and Kaiser.

Download & Print Forms


Auto Injury Forms
This lets us know more detail information regarding your car accident. All the forms may not apply to your case due to going through an attorney, third party insurance or your regular insurance company. You may just fill out the nessesary forms that apply to your case and if you are not sure which forms do apply you can always bring all the forms with you to our office and we’ll be more than happy to assist you.

Download & Print Forms – New Patients
Download & Print Forms – Existing Patients

Spanish Forms – New Patients
Spanish Forms – Existing Patients


Supplement Questionnaire

Not really sure which vitamins suit your needs? No problem, not every person is the same so not all vitamins are right for everybody. Just fill out our Supplement Questionnaire and schedule a FREE Supplement Consultation Appointment with Dr. Kelly Lucas and she will go over the Questionnaire with you and answer any questions you might have to help you decide which Vitamins and Minerals are suited best for you.

Download & Print Forms


Detox Questionnaire
Every person should cleanse the system of toxins and let the digestive tract rest at least once each year. Cleansing is one of the most direct and effective ways to improve your overall health quickly. Free radicals and toxins can build up in your body over time and may cause fatigue, poor immune function, sleep disturbances, aches, pains, and low energy. There are cleansing programs and supplements available that help the body repair and remove toxins from the body. It is generally recommended that you contact a nutrition professional when choosing a program. Just print and fill out the Questionnaire and schedule a FREE Detox Consultation Appointment with Dr. Kelly Lucas and she will go over the Questionnaire with you and answer any questions you might have to help you choose the right program or supplements that suit your needs.

Download & Print Forms


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