Almaden Chiropractic Center Online Paperwork

Health History

We offer our paperwork on line so you can complete it in the convenience of your own home. Here are the essential forms we use and why we need them.


Initial Health Status

This lets us know what’s happened...
 Download & Print Form


HIPAA (Health Insurance Portability and Accountability Act)

This document explains our obligations regarding the use of your personal information.
 Download & Print Form


Neck Pain Questionnaire

If you are visiting our office because of neck pain, please bring this completed form...
 Download & Print Form


Back Pain Questionnaire

If you are experiencing back pain, this information will help us help you.
 Download & Print Form


Free AdobeReader®

Each form is a PDF document file.  If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.

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Stress Management

A.C.C. Asks some important questions of interest to San Jose residents - Chiropractor San Jose A.C.C. Asks...

What causes subluxations?
Chiropractors acknowledge three types of stress: physical, chemical and emotional. When the adaptive capacity of your body is compromised, weakened areas along the spine can become involved. Muscles tighten, spinal joints lock up and nearby nerves are affected. The purpose of chiropractic care is to find these areas and restore balance, alignment and motion.
What's a side effect?
It may sound like a bonus; something extra, but chiropractors know it should more accurately called an "unintended effect," and "unwanted effect" or in some cases an "adverse effect." A pill can't come close to matching your body's ability to create and deliver the essential compounds it needs. That's when it's important to make sure your nervous system is working correctly—the purpose of chiropractic care!