New Outpatient Form

Prepare for Your First Appointment with Foundational Chiropractic

Welcome! To help us serve you better and ensure your first visit runs smoothly, please complete the New Outpatient Form prior to your appointment. This intake form allows Dr. Collier to understand your health history, symptoms, and treatment goals—so we can provide care that’s focused and personalized from the very beginning.

Text 214.906.1304 to schedule your appointment
 Locations in Canton and Sulphur Springs
No insurance accepted. Direct-pay only.

How to Complete the Form

Download the form using the button below

Print and fill out by hand, or fill out digitally (if enabled)

Bring the completed form to your first appointment

[Download New Outpatient Form] (PDF or fillable format – insert link here)

If you are unable to print the form, please arrive 10–15 minutes early and we’ll provide a copy to complete onsite.

Why This Matters

Your responses help us:

• Understand your full medical background
  
  
• Learn about prior injuries, surgeries, or pain points
  
  
• Identify areas needing immediate attention
  
  
• Customize your treatment strategy for best results
  

All information is kept confidential and used strictly for your care and safety.

What to Bring With You

• Your completed New Outpatient Form
  
  
• A list of any medications, supplements, or allergies
  
  
• Comfortable clothing for movement-based assessments
  
  
• Any relevant scans, reports, or prior treatment records (if applicable)
  
  

Questions Before Your Visit?

We're here to help. If you have questions about the form, your appointment, or which services are right for you, please reach out by text.

Text Only for Appointments: 214.906.1304

Thank You for Trusting Us With Your Care

We’re excited to help you feel better, move better, and heal naturally—starting with your very first visit.