Health History

We offer our paperwork on line so you can complete it in the convenience of your own home. Here are the essential forms we use and why we need them.


Patient Intake Form (Adult)

This let’s us know what’s happened, but perhaps more important, where do you want to take your health?
 Download & Print Form

Patient Intake Form (Child)

This is to let us know how we can help your child.
 Download & Print Form

Personal Injury

If your health issue is the result of a non-work related accident, we need some additional information.
 Download & Print Form


Free AdobeReader®

Each form is a PDF document file.  If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.

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Stress Management

Dr. Becky Asks some important questions of interest to Victoria residents - Chiropractor Victoria Dr. Becky Asks...

Why are some people allergic to pollen and others aren't?
It's not the pollen. Chiropractors know that if it were, everyone would be allergic to pollen, nuts and pet dander. But that's not the case. It's the person, not the pollen! If you live in Victoria and your stress levels are high, then each year the grass, the trees or the weeds put your nervous system over the top. Many report that chiropractic care helps reduce the frequency and severity of their allergic response.
Why are chiropractors wary of the germ theory?
Louis Pasteur originated the idea that germs caused disease. Yet, on his deathbed he recanted, declaring, "It's not the seed, but the soil." Meaning, it's not the germ that causes disease, but the condition of the body that allows the germ to thrive. Chiropractic care in our Victoria office is designed to bolster your resistance so germs don't see you as a good host.