New Patients

Welcome to PURE LIFE CLINIC.

We look forward to meeting you in person and helping you get back on the road to health!

We offer our new patient forms online to complete in the convenience of your home or office prior to your initial clinic visit.

What to bring to your first appointment:

Official ID – drivers license or ID card
Proof of Insurance (if you have it)

New Patient Form Instructions

All forms are PDF files. You will need Adobe Reader® to view them.
If you do not already have Adobe Reader® installed on your computer:
Click here to download.
Download the necessary form(s), print them out and fill in the required information.
Fax us your printed and completed form(s) or bring them with you to your appointment.

Learn about your rights and protections against surprise medical bills.

When you get emergency care or receive treatment from an out–of–network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing. Learn more.

Download Now

New Patient Forms

New Patient Chiropractic

New Patient Acupuncture

New Patient Massage

Motor Vehicle Accident New Patient

Pure life LISTENS to your needs, wants, questions, and concerns. They create an environment that is inviting, peaceful, and comfortable. They look at the whole physical body and your social/emotional being connected. I leave every time feeling more in tune with my body and its needs, with realistic advice that I can apply to my everyday busy life.

- Katie

I always receive a great massage when I make an appointment. Always on time, great communication, friendly therapists and staff, 5 stars.

- Gregory S

Top-notch facility. They look at the whole body and understand how to bridge holistic & modern health. Can’t speak highly enough about the team there. It’s a must. You will know with your first visit.

Monday - Friday 9:00am-5:00pm

503.288.4454

118 N Killingsworth St

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