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.


Intake Form for Chiropractic

This allows us to learn what has happened, but perhaps more importantly, it allows us to learn where you want to take your health.
 Download & Print Form


Young Person Intake Form for Chiropractic

Please complete this form for patients under the age of 18 years old.
 Download & Print Form


Intake Form for Massage Therapy

 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.

Dr. Penaluna Asks some important questions of interest to Seattle residents - Chiropractor Seattle Dr. Penaluna Asks...

Do chiropractors prescribe medications for the pain?
No. Chiropractic is a drug-free approach to better health. Instead, we rely on natural methods. We can show you how to use ice to control pain. When properly applied, ice can have an analgesic effect without the unwanted and sometimes dangerous effects of pain medications.
What's the difference between a "good" drug and a "bad" drug?
As a chiropractor, I see the use of many drugs (legal or illegal) as merely symptom treating. Worse, virtually every drug produces unwanted effects. The effects of chiropractic are largely positive effects. If you're a Seattle parent, consider carefully before giving your child a cough medication, cold remedy or pain reliever so this sort of question doesn't arise in the first place.

FREE e-newsletter

click here to subscribe