1110 Crenshaw Blvd · Torrance, CA 90501English & Japanese spoken · Hablamos español · Saturday appointments
Yajima Chiropractic
& Wellness
Your Health-Our Concern
Call (310) 626-1302

New patient resources

Printable Patient Forms

You can print and complete these forms before your visit, then bring them to the office. Forms are also available when you arrive.

Before your appointment

Two forms to prepare.

Please arrive approximately 15 minutes early for your first visit, even if you have printed the forms. Our front desk will help with any remaining paperwork.

There is no online form submission or automatic appointment booking on this site.

Registration & Health History

Patient information, symptoms, medical history, and a pain drawing. Three pages.

Open printable PDF

Office Policy & Consent Forms

Office policies, consent information, and assignment of benefits. Five pages.

Open printable PDF

Need help?

Call us before your visit.

Request an AppointmentCall (310) 626-1302