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

Can chiropractic cure a child's ear infections?
Chiropractic isn't a cure for anything. Nor is it a treatment for ear infections. However, many children who suffer with ear infections also suffer from spinal problems in their neck, compromising nerves to the ear, depressing the immune system and preventing proper drainage. Can chiropractic help? Find out!
Why does chiropractic work?
Chiropractic works because your nervous system, consisting of your brain, spinal cord and all the nerves of your body, controls and regulates every cell, tissue, organ and system of your body. A chiropractor locates and reduces areas of nervous system compromise (usually along the spine) so your capacity to heal is restored. Chiropractic works by helping your body work as it was designed.