Online Forms

UPDATE: 10/2020

Look at us growing up and learning new things!

We are adding a new feature to our clinic very soon which allows you, the patient, to fill out any new forms whether that is a new patient or you have been away for a few years. You will also be able to schedule your appointments online with ease meaning no access codes to deal with.  Watch us grow!

Coronavirus Policy

UPDATE as of 6/15/2020

We are now taking maintenance and all non-acute cases along with new patients. We are still required to take precautions by the Mississippi Board of Chiropractic Examiners, Centers for Disease Control, and Mississippi's Department of Health.

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. We also ask you to be considerate of others on the premises. If you have a mask, please wear it. We are unable to supply masks due to our limited supply.

Please call/text/email or use the patient portal for your appointment. The patient portal is available.  We are still not accepting walk-in patients due to the limited schedule.

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.
  • copy & paste this link =   

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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