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New Patient Forms


New Patient Intake

Please read the below paragraph before filling out the online form.

Here is the link to get to the necessary paperwork to become a New Patient at Ray of Light Chiropractic. Please ensure that we have scheduled you for your first visit before filling out any paper work. Failure to do so will result in all information being lost!

PLEASE remember these few things as you are filling out this information:

  • Give yourself some time to fill in this information. It may take you as long as 20 minutes to complete it.
  • Fill it in as accurately as you can, as this information will be directly loaded into our patient system, saving you as much as 1 hour in our office. :-)
  • SIGN THE FORM FIRST. Go all the way to the bottom of the form, when you get to the signature portion, USE YOUR MOUSE to sign by holding down the left mouse button and signing your name. Then go back up to fill in the form. We don't want you to lose your entered information by trying to figure out how to sign the form.
  • DO NOT exit off the page. YOU WILL LOSE YOUR INFORMATION. Stay on the page until you are through and the information has been submitted.
  • Please enter as many symptoms as you are experiencing, you may enter as many as four (4). In order to add additional areas of discomfort as additional complaints, select Yes in response to "Do you have an additional complaint?" right before the section "Review of Symptoms."
  • Once the information has been submitted, you will receive a message stating it was sent.
  • Please remember this information needs to be filled out on a computer NOT a tablet or smart phone.

Please call our office at (978) 887-9889 and speak with Lois or Rachel if you have any questions or problems with completing your new patient paperwork, please do not hesitated to contact us we will be happy to help guide you through it.

Click Here To Access The Chiro Touch Patient Intake Form

Contact Us Today!

We look forward to hearing from you.