If you’re a new Asha patient and want to fill out your forms ahead of time, please download, print and fill out the following:

Asha New Patient Intake & Consent to Treat

If you’re a new Chiropractic patient, please also print and fill out the following:

Chiropractic Intake Form

For all patients – we take your privacy very seriously and protect it very carefully. If you’d like to read more, please refer to our:

Notice of Privacy Practices. HIPAA

If you’re a new patient with another of our providers, for acupuncture, massage, naturopathic care or other services, please also print and fill out the appropriate form for them.  Not all providers have intake forms, or provide them through the front desk. If you don’t see an intake form for your provider, we’ll get you taken care of when you come in for your appointment.

Please bring those forms with you to your appointment. If you have any questions, or want to book an appointment, please contact us:

phone: 503-719-5000

fax: 971-255-1754

address: 2100 NE Broadway, Suite 225, Portland, OR, 97232