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Dr. Kim, DC's Health & Chiropractic Clinic offers our patient form(s) online so they can be completed  in the convenience of your own home or 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!

Download & Print Form


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or 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!

Download & Print Form



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Exclusive Offer

New patients receive 15% OFF first visit.
Sign-up using the form or call us at 408-360-9508 to take advantage of this exclusive offer.

THIS ---->https://drhey.chiromatrixbase.com/new-patient-center/online-forms.html

Office Hours

DayOpenClosed
Monday8:00am6:00pm
TuesdayClosedClosed
Wednesday8:00am6:00pm
ThursdayClosedClosed
Friday8:00am6:00pm
SaturdayClosedClosed
SundayClosedClosed
Day Open Closed
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8:00am Closed 8:00am Closed 8:00am Closed Closed
6:00pm Closed 6:00pm Closed 6:00pm Closed Closed

Testimonial

This was not my first time seeing a chiropractor. I was a regular in Hawaii, but since I've relocated I needed one pronto. I was delighted when I met Dr. Kim. He is very accommodating and has an affable manner. He gave me some great stretching techniques and I did not feel rushed through my visit ( I was a little late). I think that if you are going to see a chiropractor for the first time, take a moment and see Dr. Kim.

Pamela B.
San Jose, CA

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