Online Forms

Coronavirus Policy

Due to COVID-19 and the Mississippi Board of Chiropractic Examiners, Sanchez Chiropractic Center is only taking acute and new patient cases at this time. Wellness, maintenance, and non-acute cases have been rescheduled.

We are taking precautions by asking that you please make appointments to practice social distancing, decreasing, and minimizing wait time to help with flattening the curve.

Please call/text/email or use the patient portal for your appointment.

UPDATE as of 4/8/2020

We are still open!     In accordance with the Mississippi Board of Chiropractic Examiners, CDC, and Mississippi Department of Health, we have made changes to our office procedures. We do have patient instructions posted on the door entering our office. We ask that you please adhere to the new policies:

1. Bring your own pen/pencil to sign in. We have taken up all writing utensils, reading materials, and child toys along with chairs that did not adhere to the 6 feet social distancing.

2. Please sign in on the sheet (this allows us to know you have arrived at your scheduled time) and wait in your car until we can text or call you when a clean room is available.

3. Please only one person during each visit if at all possible. No more than 2 persons if adult is accompanying a child.

4. Once in the building, we will take your temperature and ask multiple questions in regards to the COVID-19 response.

5. Please rest assure that we have cleaned in between patients on all high touched surfaces along with all equipment used in each visit. We also are required to use masks and gloves before, during, and after each visit for prevention.

We appreciate your patience during this crucial time.

Sanchez Chiropractic Center, P.C. offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

  • 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.
  • You can also go online to register on the patient portal. You will need an email to send a verification code in order to proceed. Any questions, call 662-423-9315.
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New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Registration Forms

Download & Print Child Registration Forms

Notice of Patient Privacy Policy

Release of Private Information

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