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 Patient Forms 
Patient Forms
 

For ALL new patients: Please use the link listed below, print and fill out your forms and bring them with you on your initial visit.

For patients who have an appointment for a EDS Screening: Please fill out your forms and bring them with you on your initial visit.

If you have any problems with the forms , please call 320-597-8999 and we will be glad to help.
HIPAA / AUTHORIZATION FORM

Please print out and read before your appointment. Sign and bring with to your appointment.

Thanks...Regional Health Center, Inc.
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Regional Health Center Chiropractic
Dr. Jennifer  Doll
307 Ivy Ave. SE  ~  Richmond, MN
320-597-8999
300 Avon Ave S  ~  Avon, MN
320-356-1023
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