Dr. Michele Imossi - Chiropractic Physician
New Patient Forms

Save time at your office vist by printing out and filling in the paperwork ahead of time. Make sure to tell us that you will be bringing in your paperwork, so that we schedule you accordingly. To schedule an appointment call : (860) 828-3435. We look forward to meeting you soon!
Please click onto and then print out the forms below that apply to you.  (All new patients will need the first form.  In addition, patients with neck pain, back pain and/or injuries from an accident will need to print those additional forms.):  

1. For All New Patients: New Patient Case History Form

2. All Patients: Privacy & Consent Forms

3. Neck Pain Questionnaire - Only for Patients with Neck Pain

4. Back Pain Questionnaire - Only for Patients with Back Pain

Thank you and we hope to help you soon!