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541.757.9933 H
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541.757.9933

Online Forms

Heresco Chiropractic & Associates offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History & Welcome Form - Required

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 and print this form for your New Patient Visit! /clients/2489/documents/Online_New_Patient_Forms_03.2016.pdf

Additional Health Questionnaire Forms-

If you made an appointment due to a motor vehicle accident: /clients/2489/documents/MVA_and_PI_Website.pdf

If you are making an appointment due to an injury which occurred at work:

Download & Print Form


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form



Download the Free AdobeReader®

Notice of Privacy Practices

Sport Physicals

Sign-up using the form or call us at 541.757.9933

Office Hours

Day
Monday8:00 am6:30 pm
Tuesday8:00 am6:30 pm
Wednesday8:00 am6:30 pm
Thursday8:00 am6:30 pm
Friday8:00 am6:15 pm
Saturday9:00 am4:30 pm (After 4:30 - Physician On Call)
SundayPhysician On Call
Day
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8:00 am 8:00 am 8:00 am 8:00 am 8:00 am 9:00 am Physician On Call
6:30 pm 6:30 pm 6:30 pm 6:30 pm 6:15 pm 4:30 pm (After 4:30 - Physician On Call)

Sport Physicals

NEWS:

Appointments are now being scheduled
for school sports physicals

541.757.9933

Call Us Today!


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Corvallis Chamber member

541.757.9933

Call Us Today!