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.


This let’s us know what’s happened, but perhaps more important, where do you want to take your health?

Patient Intake Form

 Download & Print Form

Pediatric Intake Form

 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.

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Drs. Duckwall and Grushon Asks some important questions of interest to Yellow Springs residents - Chiropractor Yellow Springs Drs. Duckwall and Grushon Asks...

Where do most Yellow Springs residents get their first subluxation?
Being born in a hospital is a common source of subluxation. Trauma from forceps delivery has been replaced with drugs, vacuum extraction, Cesarean section and births that are "scheduled" to fit the workweek routines of Ob-Gyns. That's why we recommend a chiropractic checkup for every Yellow Springs newborn.
What's the difference between chiropractic and medicine?
Medical treatment focuses on the disease or the symptom. Chiropractic focuses on the person with the disease or the symptom. Medical treatment usually involves changing blood chemistry. Chiropractic involves restoring nervous system integrity. Medical doctors prescribe medicine. Chiropractors adjust the spine—a common source of nervous system interference.