New Patient Questionnaire

Before you begin chiropractic care, we need to understand your health history and your health goals.

Print the appropriate form below out and fill it in before you arrive for your first visit.

Click Here Please click here to download our Adult New Patient Questionnaire.



   Please click here to download our Child New Patient Questionnaire.
Ages 6 - 16.


   Please click here to download our Baby New Patient Questionnaire.
Ages Birth - 5 Years

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Dr Ross Asks some important questions of interest to Rockingham residents - Chiropractor Rockingham Dr Ross Asks...

How could chiropractic help a stomach problem?
Chiropractic works by locating and reducing areas of the spine compromising nerve communications between your brain and your body. If nerves to or from your stomach are irritated, your stomach won't work right. Chiropractors find the source of the interference, reduce it and allow your body to work as designed.
What controls every cell, tissue and organ of your body?
DNA? Wrong. Immune system? Wrong? Hormones? Wrong. It's your nervous system, consisting of your brain, spinal cord and all the nerves of your body. When a chiropractor sees a Rockingham patient with say, stomach problems, we want to know why the brain is unable to properly control and regulate the stomach. Which prompts us to examine the nervous system—the focus of chiropractic care.