Online Forms

Online Forms

Tucson Chiropractic Spine and Injury Center offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • No Surprise Act-Link
  • 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.

New Patient Protocol for Records

Chiropractic Registration and History

Protocol for Preservation of Patient Records

Acknowledgement of Patient's Records Preservation

Vehicle Accident Information (if applicable)


Additional Patient Forms(please print and complete the corresponding forms for your area of pain)

Neck Disability Index Questionnaire

Neck Bournemouth Questionnaire

Revised Oswestry Back Pain Disability Questionnaire

Back Bournemouth Questionnaire


Download the Free Adobe Reader®

Standing Taller

Why We're Your First Choice for Chiropractic Care
  • Free Consultations Available to All New Patients
  • Upper Cervical Treatment & Atlas Orthogonal Adjustments Available
  • Decompression Table, Ultrasounds & Other State-of-the-Art Technology
  • One of Few Chiropractors in Tucson with an Advanced Certificate for Whiplash
  • Creates Unique Treatments for Each Patients' Needs

Patient Testimonials

Experiences & Opinions
  • “He is FANTASTIC!!”

  • “He is the first provider I've had that has been able to eliminate neck pain that had been present for over 20 years.”

  • “I have seen many chiropractors across many states and NOT ONE compares to Dr. Cross”

Send A Message

We'd Love To Hear From You

Please use the form below to request an appointment, or if you have any quesitons or concerns we can assist you with.

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