New patients at Hanna Chiropractic Wellness Center are asked to complete several important questionnaire forms. This information is required to assure you will receive the best medical care.

When you arrive for your first appointment you will be asked to complete a general information form. This information relates to basic family and financial information. Your physician will request that you complete a medical history form and the receptionist will photocopy your insurance cards.  HIPAA privacy forms will also be completed, per new federal law.

These forms are available for printing. Click on the links below to view them. They are in Adobe Acrobat format (PDF)

If you are a current patient, please select the appropriate form given to you from the doctor and bring the results to your next scheduled visit.  

Links to Forms

• New Patient Form
  
• Braverman Assessment
  

Additional Details

Please print out your completed forms and bring them into the office for your next visit.

Need More Information?

Contact Dr. Wendy Puchalski at:

Hanna Chiropractic Wellness Center

27907 La Paz Rd. Suite I

Laguna Hills, CA 92677