Online Forms

Smith Family Chiropractic offers our patient forms online so you can complete them when it's convenient for you

It's as easy as 1.2.3…

1. Need AdobeReader® installed on your computer? Click Here to download.

2. Download the necessary form(s), print it out and fill in the required information.

3. Fax us your printed and completed form(s) or bring it with you to your first appointment.



This gives us the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Choose from the forms based on what best fits your needs. If you have questions about which form to choose please call our office.

Pediatric Forms

New Patient Form

Personal Injury Form

Dr.Smith is also certified to do D.O.T Physicals, just give us a call(912-487-2288) and set up an appointment today.