Patient Intake Forms

Download, print and fill out our paperwork in the comfort of your home.

Click the download button below to download our paperwork as a PDF Document and simply bring them with you to your next visit with Dr. Croucher.

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In order to view and print our intake forms you must have Adode Reader. If you don't have Adobe Reader you can click the "Get Adobe Reader Button" to download and install it from the official adobe website.

It's free, safe, and takes less than 2 minutes.

Have A Question About Being a New Patient? 315-635-2333

  • Intake Forms

    Download and Print our intake forms.

  • My First Visit

    What to expect at your first visit.

  • Payment Options

    Affordable care for everyone.

  • Gallery

    Photos of Upstate Chiropractic

Patient Reviews

Craig Ellsworth

I want to take a minute to say I LOVE Upstate Chiropractic. I've followed Eric and His staff from 2 moves of their practice.
Eric , Micky and all the personal are so understanding and positive in their treatment of each and everyone's pain ..

Shannon Priest

Without question one of the best chiropractors in the area! Dr. Eric takes the time to know and understand your health. He
takes great care in helping you obtain optimal health. His staff is welcoming, knowledgeable and accommodating. I
wouldn't take my family to anyone else!!!

Terra Lee

I know there is so much controversy between chiropractic and medical care, but if it were not for chiropractic I would still be in pain. A car accident left me with constant back pain. I tried everything from painkillers to preparing to have surgery. I heard stories from my friends who had surgery and to this day wish they never had it. I decided to go to Dr. Croucher before the surgery and I am so thankful that I did. My back pain is 95% gone and my life has changed because of Dr. Croucher. Thank you so much!

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