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Online Forms

Haynes Chiropractic offers our patient form(s) online so they can be completed it 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!

Download & Print Form

Auto Accident Injury Form

Download & Print Form


If you do not already have AdobeReader® installed on your computer, Click Here to download.

Talk it over with Dr. Haynes

Questions about your back, neck, posture or your next DOT physical? Call the office and we’ll find you a time, often the same day.

Jeffrey D. Haynes, D.C. was born and raised in Bakersfield and has run Haynes Chiropractic on Stockdale Highway since 1995. More about Dr. Haynes.