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Dr. Rhinehart's Online Forms

Crossroads Health Center offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know! The more we understand your symptoms and concerns the better we can determine what's wrong and if we can help.

Simply print out the following forms, complete them and bring them in to our office We look forward to seeing you soon!

Form # 1- New Patient Intake Form

Form #2 - Metabolic Assessment Form

Form #3 - Health Questionnaire Form

Form #4 - Pain Drawing Form

Form #5 - Office Policies



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