Chiropractic Intake Forms

A new patient intake form, a health history, and an informed consent form come first. Questionnaires for the neck, back, or shoulder track progress over time. Auto accident and workers' comp cases add forms about the injury.

The main complaint, where it hurts, when it started, what makes it better or worse, and how it affects daily life. It also covers past injuries, surgeries, medications, and earlier chiropractic care.

Both are standard disability questionnaires. Each has 10 sections scored 0 to 5, for a total out of 50. The Oswestry covers low back pain, and the Neck Disability Index was adapted from it for neck pain. Repeating them at re-evaluations shows change over time.

The form records how the accident happened, where the patient sat, the symptoms since, and other care received. Insurance claims often depend on these details, so the practice documents them from the first visit.

A parent or guardian fills them in and signs a consent to treat a minor. Newborn forms ask about pregnancy, birth, feeding, and sleep. Forms for older children add school, sports, and activity questions.

AI Doctor, a real-time AI healthcare assistant avatar, asks the intake questions as a conversation, in the patient's own language. It collects the answers for the chiropractic team to review before the visit.

No. It collects information for the care team. It doesn't diagnose, triage, or recommend treatment.

Yes. RAVATAR offers on-prem deployment: the platform can run inside your own perimeter, so patient answers stay there. RAVATAR complies with GDPR and the EU AI Act.