Dr. Loren Marks offers our patient forms online so they can be completed in the convenience of your own home or office before you even arrive in our chiropractic office.

• If you do not already have AdobeReader® installed on your computer, Click Here to download.
• Download the necessary form(s), print it out and fill in the required information.
• Fax us your printed and completed form(s) or bring it with you to your appointment.

Fees

Initial Chiropractic Examination- $150.00

Initial Functional Medicine Nutrition Consult $375.00

Integrative Genetic Solutions Report and Review Recommendations $500.00

Intake Forms

Please print the appropriate forms for your visit, fill them out and bring them to your visit to expedite your waiting room time. If you’d like, you can even email them to us at [email protected] or fax to 212 399 9659

We look forward to making your experience with our office and website more interactive and rewarding!

Patient Registration Forms -  Download & Print Form

Questionnaire

Detox Questionnaire - Download & Print Form

Notice of Privacy Practices- Please sign the receipt and attach to your New Patient Forms

Keep The Notice of Privacy Practices for your records - Download & Print Form