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918-272-0303

Drake Chiropractic, PLLC. offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.


New Patient Forms

All four forms needed. Please fill out completely front and back.

New Patient Intake Form

Informed Consent

Privacy Policy

Terms of Acceptance

Have you been in an automobile accident?

Please fill out the following two forms in addition to the above.

Automobile Accident Questionaire

One form for each medical facility visited prior to your Chiropractor.

Records Request Form


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form



Download the Free AdobeReader®

Sign up using the form below or call us at 918-272-0303.

Office Hours

Day
Monday9:00-1:003:00-6:00
Tuesday9:00-1:003:00-6:00
Wednesday9:00-1:003:00-6:00
Thursday9:00-1:003:00-6:00
Friday9:00-1:00Closed
SaturdayClosedClosed
SundayClosedClosed
Day
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
9:00-1:00 9:00-1:00 9:00-1:00 9:00-1:00 9:00-1:00 Closed Closed
3:00-6:00 3:00-6:00 3:00-6:00 3:00-6:00 Closed Closed Closed

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