Patient Forms

Please use the following links to print and fill out our insurance coverage and patient health history forms. The forms are in the PDF format; in order to view them you will need a PDF viewer such as Adobe Reader. If you do not have Adobe Reader you can click here to download it FREE.

General Forms

Health History Forms

Financial Policy And Payment Options Forms

 

Special Forms

Auto Accident Form

Work Injury Form

Pediatric Health History Form

Infant History Form

Pre-School Child History Form

School Age Child History Form


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Featured Services

  • Wellness For All

    We would like to invite you to a class that we believe will make a huge difference in the enjoyment of your life and in the lives of your family. Let's talk about how you can Stay Young The First 100 Years... Read More

  • What To Expect

    You can expect PROMPT service! We have all been put through the dreaded hour long wait in a doctor’s reception area with year old magazines. In our clinic, you won’t have to bring a 500 page book... Read More
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Symptom Center

  • Asthma +

    Asthma can be defined as a reversible narrowing of the large and small airways due to spasm of the bronchial… Read More

  • Bursitis +

    Bursitis is the Inflammation of the fluid-filled sac (bursa) that lies between a tendon and skin, or between a tendon… Read More

  • Carpal Tunnel Syndrome +

    Carpal Tunnel Syndrome is the compression of the median nerve at the wrist, which may result in numbness, tingling, weakness,… Read More

  • Ear Infections +

    Ear Infections or Otitis media is an inner ear infection generally caused from a blockage of the Eustachian tubes.  The… Read More

  • Fibromyalgia +

    Fibromyalgia is a common condition characterized by widespread pain in joints, muscles, tendons, and other soft tissues.  Some other problems… Read More

  • Joint Disease +

    Joint disease is one of the oldest, and most common types of arthritis.  It is characterized by the breakdown of… Read More

  • Low Back Pain +

    The majority of back pain patients have not experienced any trauma, accidents or major injuries prior to the onset of… Read More

  • Osteoporosis +

    The thinning of bone tissue and loss of bone density over time.  Osteoporosis is the most common type of bone… Read More

  • Pregnancy +

    Improve your pregnancy with chiropractic care. Today's woman constantly juggles an incredible number of responsibili-ties: jobs, children, friendships, marriages, errands, appointments… Read More
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Contact Us

Back, Body & Beyond Chiropractic
901 Dupont Rd., Suite 102
Louisville, KY 40207
(502) 618-3745

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The contents of this website including text, graphics, images, and other materials are provided for informational purposes only and is not intended to be a substitute for professional health advice, diagnosis, or treatment. Privacy Policy