forms

requirements

Bentleyville Chiropractic offers our office forms online so they can be completed in the convenience of your own home before you even arrive to our office.


Instructions: Download the following 7 pages and print them out. Simply fill in the required information and bring them with you to your appointment.


There are 7 pages total.

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DOT forms


Instructions


Driver,
There will be a total of 5 sheets to print out. Please fill out your sections on pages 1 and 2. Bring the other sheets with you. There in an instruction sheet to help you.

Please be prepared: Have your Medical History, Medications, Exemptions, Diabetes Logs, C-Pap Logs, Family Dr's name, Stress test results, Pulmonary function Tests etc. available at the time of appointment. We are doctors not detectives. If you do not have your information available to us, we will not be able to examine you that day.

See you at your appointment!

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