Welcome to the Family!
Now that you have signed up to be a CHIROFIT provider, let's get you some paperwork! Below you will find a few PDF's you can download to print in your office. This includes the New Patient Intake, Patient Evaluation Exam, Assessment/Treatment Plan, and SOAP Note. We have also included a Reference Set with Key Abbreviations and Common ICD-10 Codes for your convenience. Be sure to check back here in the future for updated versions.
If you have a patient that requires more medical care following an Auto Injury, our team has you covered. Simply fill out our AZMEDINJURY Referral to get them the care they need and deserve.
New Patient Intake rev. 01/2020
Assessment / Treatment Plan rev. 08/2018
Patient Evaluation Exam rev. 08/2018
AZMEDINJURY Referral Form rev. 05/2018
Contact Reference Sheet Rev. 08/2018
Need to Know How to Fill Out These Forms?
See the attached forms here for a sample set of filled-out paperwork. This will help guide you along with the proper way to fill out the CHIROFIT forms. Still have questions? Email us at care@chirofitgroup.com with your questions and we'll get you going in the right direction!
Sample form is not specific to the diagnosis and is designed to give examples of how to fill out different areas.
Need Something else?
