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Please download and print the appropriate document. Once you have filled out the requested information, you can scan and email it back to contact@chappchiropractic.com or mail to 

9090 South Rodgers CT. SE, Suite B., Caledonia MI, 49316 

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If you have any questions, please contact us at contact@chappchiropractic.com or call us at 616-698-6981

Records Release from Burkhart Chiropractic to Chapp Chiropractic

Records Release from Other Care Providers to Chapp Chiropractic

 New Patient

Application for Care and Informed Consent Forms

Patients of Dr. Chapp from his Previous Office

Informed Consent Form

All Patients
Notice of Privacy Practices  Acknowledgement and Medical Information Release Forms

All Patients
(Read Only)
No Suprise Act: Good Faith Estimate (GFE) Information Document 

All Patients
(Read Only)
Chapp Chiropractic, PLLC Notice of Privacy Practices Booklet

All Patients
(Read Only)
HIPAA Notice 

©2021 by Chapp Chiropractic, P.L.L.C..

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