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Request Appointment


East Otterman Chiropractic offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic 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.

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!

To access this paperwork, you must first call the office (724-838-7700) or e-mail us (eottermanchiro@aol.com) so that we may provide you with a username and password.  Please have your insurance information available when you call to make your appointment and acquire your username and password. 

Please use the link below to access the new patient paperwork once you have your username and password.  If you do not have access to the internet, you may pick up your paperwork from the office or we can fax it to you.


Member Wellness Registration

Please sign up for our monthly newsletter to keep up on current health issues and news and events in our chiropractic office.  Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

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