Patient Forms

In order to help you prepare for your first appointment, we have the following patients forms

for you to download, print, and fill out prior to your first visit.
Please be sure to download and print all forms below:

Form 1

Patient Information and Injury History Form

Form 2

Patient Symptoms

Form 3

Activities of Daily Living

Form 4

Auto Accident Info / Work Comp Injury

Call or E-mail Today for Your Appointment!

Type of inquiry, Chiropractic or ARP Wave



Chiropractic Healing Arts Center

85 E Street   South Portland, ME  04106   Phone:  207.799.0972  Fax:  207-799-4966

Dr. Fawn R. Dunphy, Chiropractic Healing Arts Center


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