Online Forms

Download & Print FormEriksen Chiropractic Laser Center offers our patient forms online so they can be completed in the convenience of your own home or office. Please download and fill out the paperwork below.

  • If you do not already have AdobeReader® installed on your computer, click here to download.
  • Fax us (334-792-0210) your printed and completed form(s) or bring it with you to your appointment.

Patient Case History Form

Download & Print Form


Confidential Patient Information Form

Download & Print Form


Informed Consent Form

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HIPPA Privacy Practices

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Please Check with Staff to See if Any of the Forms Below Need to be Filled Out

Motor Vehicle Accident Form

Download & Print Form


Neuropathy History Form

Download & Print Form


Knee Pain History Form

Download & Print Form


Foot Pain History Form

Download & Print Form


Zerona Laser History Form

Download & Print Form


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Our Locations

Office Hours

Monday:

8:00 am-12:00 pm

2:00 pm-5:30 pm

Tuesday:

8:00 am-12:00 pm

2:00 pm-5:30 pm

Wednesday:

8:00 am-12:00 pm

2:00 pm-5:30 pm

Thursday:

9:00 AM-12:00 pm

2:00 pm-4:30 pm

Friday:

8:00 am-12:00 pm

Saturday:

Closed

Sunday:

Closed