Living Pure Chiropractic & Acupuncture offers our patient form(s) online so they can be completed in the convenience of your own home or office. To schedule with Dr. Dias please send a message here.
- 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) to 623-566-4918 or bring them with you to your appointment.
- We ask that you arrive 15 min early with completed forms, 40 minutes early to fill out forms in our office!
New Patient Health History Form
Download & Print Form ( Español)
Auto Injury New Patient Forms