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Online Forms




Rocky Mountain Chiropractic & Sports Injury Centers offers our patient form(s) online so they can be completed in the convenience of your own home or office.


RMCSIC Intake Packet
Please download and complete this Intake form before your first visit. If you are unable to complete this form in advance, please arrive to your first appointment about 20 minutes early and you are welcome to fill this paperwork out at that time.  If you received these forms in your email and filled them out you have already completed this paperwork and will not need to print this packet.  

Once you download and complete the form, SAVE it and then email it back to us by replying to your welcome email.  Your welcome email was from our gmail account.  We do not post that address on the web, as an alternative, send the forms to: [email protected]

Download and Complete Forms


Sports Physical Health History

Please download and complete the first page of the attached sports physical health history.  The second page will be filled out by Dr. Hextell during the examination. Please simply write the athlete's name and Date of Birth at the top of the Examination Page.

Once you download and complete the form, SAVE it and then email it back to us by replying to your welcome email.  Your welcome email was from our gmail account.  We do not post that address on the web, as an alternative, send the forms to: [email protected]

Download and Complete Forms


X-Ray Request Form
If you had an x-ray, CT Scan or MRI at the hospital or another office since your accident, please fill out the x-ray release form so that we can examine those studies.

Download and Complete Forms


Pediatric Health Screening and Consent
If the Chiropractic Care is for a Child, please download and complete the attached child intake and health history so that we may provide your child with the best care possible.

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Motor Vehicle Accident Patients:   Initial Visit Packet

If you were involved in a motor vehicle accident, you have come to the right place. Please fill out the attached paperwork before your first visit. Be sure to include claim numbers and fill this packet out in detail. It will help make sure you receive the best possible care and that your case is well documented for insurance and attorney purposes. If you had an x-ray, CT Scan or MRI at the hospital or another office since your accident, please fill out the x-ray release form so that we can examine those studies.

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Appointment Request Form

Please provide 1-2 alternative times.

Location & Hours

Location

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Office Hours

Our Regular Schedule

Office Hours

Monday:

8:00 am-12:00 pm

2:00 pm-6:00 pm

Tuesday:

8:00 am-12:00 pm

2:00 pm-5:00 pm

Wednesday:

8:00 am-12:00 pm

2:00 pm-6:00 pm

Thursday:

Closed

Friday:

8:00 am-12:00 pm

2:00 pm-6:00 pm

Saturday:

8:00 am-12:00 pm

Two Weeks per month

Sunday:

Closed