Please Select a Form New Patient Forms (Insurance and/Or Cash) New Patient Forms (Personal Injury) New Patient Forms (Pediatric) Click on a form below to download and fill out before visiting our office! Choose Appointment Type * RequiredAuto Injury AppointmentWork Injury AppointmentNew Patient AppointmentPediatric AppointmentReactivation Appointment Auto Accident Intake Form Please click on the fillable PDF below to complete the Auto Injury Intake Form. After you complete this form, you can send this document directly to us without having to print anything. To do this: Save document Email attachment to: Crofton: eihcrofton@gmail.com Millersville: effectivechiropractic1@gmail.com CT Intake Form - Millersville CT Intake Form - Crofton Coming Soon Pediatric Form (under 8 years old) CT Intake Form (8-17 years old) - Millersville CT Intake Form (8-17 years old) - Crofton Patient Update Form Schedule Your Free Consultation Today! Contact Us