Before your first visit

All New Clients:

Welcome to Clear Point Wellness! We look forward to helping you with your health goals.  Below are forms for each of our doctors and practitioners.  Please check out the section relevant to your first visit with us.  For all our new clients, please remember:

  • Arrive 15 min. before your appointment to complete daily paperwork, rest, and relax before your session.
  • Bring your paperwork with you (found below).
  • If you are not bringing your paperwork with you, please arrive 45 min. early for your first chiropractic appointment in order to complete an extensive history, and still have all your time available to you in session.
  • Some of our clients are chemically sensitive, in an effort to maintain a healing environment for them, please wait to put on perfume, cologne, essential oils, or scented lotions until after your appointments with us.

Thank you for your assistance – we look forward to seeing you!

Chiropractic New Clients:

>CPW Health Survey SF36 – Adult

>CPW Chief Complaint

>CPW HIPAA Privacy Policy*

>CPW HIPAA Right to Share

Additional forms for Dr. Lisa Hastings’ New Clients:

>Adult Health History LH

Additional forms for Dr. Summer Van Schouwen’s New Clients:

>Adult Health History SVS

> Nutritional Questionnaire

Additional forms for Dr. David Jones’ New Clients:


Additional forms for New Clients with various conditions:

>CPW Oswestry Low Back Pain Scale
>CPW Oswestry Neck Pain Scale

We are a family-oriented practice and welcome children of all ages. Children of our current clients (under 18 years old) are eligible for reduced fees. If you bring your child for chiropractic care, please complete this form:

>CPW Health History – Minor

Biomechanical Movement New Clients

>Biomechanical Movement Intake


* This is our full  > HIPAA information if you are interested in reading it.