Online Paperwork

We offer our paperwork on line so you can complete it in the convenience of your own home. Here are the essential intake forms for our office.


Intake Form - Ages 18 and over

 Download & Print Form (18 and over)


Intake Form - Ages 10 - 18

 Download & Print Form (10 - 18) 


Intake Form - Ages 10 and under

 Download & Print Form (10 and under)


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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Dr. Priestley Asks some important questions of interest to Corona del Mar residents - Chiropractor Corona del Mar Dr. Priestley Asks...

Do nerves actually get pinched?
Chiropractors recognize two types of nerve disorders involved in subluxation. The least common is a pinched nerve that diminishes nerve supply to an affected organ or tissue. More common is the irritated nerve (facilitative lesion) which overexcites nerve communications to an affected organ or tissue. Chiropractic care has been shown to help with both types.
What controls your pulse, blood pressure and cholesterol?
Conventional health care focuses on the various aspects of your blood. But these are merely effects. Chiropractic focuses on the integrity of your nervous system that controls, regulates and monitors every aspect of your circulatory system, every aspect of your body and every person in Corona del Mar.