The Attica Chiropractor to see - Chiropractor Attica

Online Paperwork

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.

Health History Adult

Ages 13 and over. This let’s us know what’s happened, but perhaps more important, where do you want to take your health?
 Download & Print Form

Health History Child

Infants up to ages 12. This let’s us know what’s happened, but perhaps more important, where do you want to take your health?
 Download & Print Form

Patient Request for Records

If you have received chiropractic care elsewhere, or have medical records we will need from another practitioner, please sign this release.
 Download & Print Form

Automobile Accident

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

Privacy Policy

How we protect your privacy.
 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.



Dr. Gary Schaaf, 4534 S St Rt 4, Attica, OH | (419) 426-4501
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Dr. Gary Asks some important questions of interest to Attica residents - Chiropractor Attica Dr. Gary Asks...

What's the difference between sick care and health care?
Sick care is largely about relieving or suppressing symptoms. Health care is about improving performance. While sick care is about how you feel, health care is about how you function. Sick care is what you do to treat an obvious problem, and health care is what you do to avoid the problem and advance your well-being.
How do you "catch" a cold?
Simply lower your resistance by avoiding the proper rest and exercise, eating lots of sugar and junk food, putting up with emotional stress and neglecting your nervous system by avoiding your chiropractor. You won't have to catch a cold because it will catch you!