Online Forms

At Natural Potential Chiropractic, we offer patient forms online so you can complete them in the convenience of your own home or office. Fax us your printed and completed forms or you may bring them during your visit.

Direct submission of Online forms
Click on the link below to open our online intake form. Please complete all questions and fields in the below questionaire to the best of your ability. The information provided will be entered directly into your file so nothing gets lost in the transition! We look forward to the opportunity to go over each answer with you as we learn more about your healthcare goals and how we can assist you in achieving them!

Click Here For Online Intake Form

If you are pregnant or filling out the intake forms for your children, please print off the paper forms below because they are more specific to your needs as a parent or mother to be!

Download and Print Parent Questionnaire for Children with Learning/Behavioral Difficulties

Download and Print Pediatric Intake Form

Download and Print Pregnancy Intake Form

If you do not have AdobeReader® installed on your computer, Click Here to download.

What Our Patients Say

I had been struggling with neck pain for years and finally went to a chiropractor for the first time recently. I was very pleased with Dr. Carr and his staff. They were friendly and professional. Dr. Carr did an amazing job, not only with my adjustments and explaining what was happening, but also with tips on how to carry myself so I could prevent future issues. I highly recommend him as a chiropractor.

Bethany B.

I am glad we found this place. Dr Carr really wants you to feel well. He is so good with children too. He has adjustment tables out in the open as well as in closed rooms. After seeing how gentle the Dr. is with other children, my son finally let a chiropractor treat him and has never felt better.

Edwardough G.

Great chiropractor. Entire staff is helpful and knowledgeable. Very much recommended

Clifton M.

Dr. Carr and the staff are simply awesome! They have created a family atmosphere that makes it easy to feel comfortable. Dr. Carr is very personable, knowledgeable, and really knows his craft. I had never been to a Chiropractor before visiting Dr. Carr and see no need to visit anyone else. He is tremendous and helped bring great healing to my ailing back. I highly recommend this office.

What Our Patients Say

Bethany B.

Edwardough G.

Clifton M.

Tim J.