Health History

We offer our paperwork on line so you can complete it in the convenience of your own home. Here are the essential forms we use and why we need them.


Health History and Future

This let’s us know what’s happened, but perhaps more important, where do you want to take your health?

  Adult - Download & Print Form


  Child - Download & Print Form

Automobile Accident

If your health issue is the result of a car accident, we need some additional information.

 Download & Print Form


Worker’s Compensation

If your health issue is the effect of an injury at work, this information will help us help you.

 Download & Print Form


Massage Intake

Please complete the attached massage intake forms.

 Download & Print Form


Free AdobeReader®

Each form is a PDF document file.  If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.

Call today to make your appointment.




Dr. James Dougherty, 2272 Downer St., Baldwinsville, NY | (315) 635-1231

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Dr. Dougherty Asks some important questions of interest to Baldwinsville residents - Chiropractor Baldwinsville Dr. Dougherty Asks...

Can someone who has had back surgery receive chiropractic care?
Yes. Rest assured that we will avoid the surgically modified areas of your spine. However, what we find is that surgical interventions will often produce spinal instability above or below the involved level. This is will be the focus of your chiropractic care.
What's the difference between maintenance, prevention and wellness?
Maintenance chiropractic care is an attempt to keep a dynamic, ever-changing and adapting organism (you) in a static relationship with your environment. Preventive chiropractic care is mostly about early detection. Wellness chiropractic care is an attempt to optimize our health and be all that you were designed to be.