Intake Forms
Energize Chiropractic and Wellness offers our patient form(s) online so they can be completed in the convenience of your own home or office.
- All forms are PDF files. You will need AdobeReader® to view them.
- If you do not already have AdobeReader® installed on your computer, Click Here to download.
- Download the necessary form(s), print them out and fill in the required information.
- Fax us your printed and completed form(s) or bring them with you to your appointment.
The form below can be completed online.
Monday
8:00am - 1:00pm
2:00pm - 6:30pm
Tuesday
9:00am - 6:30pm
Wednesday
8:00am - 1:00pm
2:00pm - 6:30pm
Thursday
8:00am - 1:00pm
2:00pm - 6:30pm
Friday
Closed
Saturday
Closed
Energize Chiropractic and Wellness
13325 100th Avenue NE Suite D
Kirkland, WA 98034
Phone: (425) 814-9644
Fax: (425) 814-7395

2014 Best of Western Washington Award