Optilife Patient Forms



No Matter what your need may be, our friendly staff will get it done.  See below for links to our new patient forms and general information.

Our flexible scheduling is designed to accommodate your schedule.  We will help with insurance forms, referral appointments, insurance verification, work and school letters or anything else we can do to make your life a little easier.  Count on us for:

  • Friendly support
  • Flexible scheduling
  • Excellent Care
  • Advanced Physical Therapies
  • Insurance and billing assistance

New Patient Forms:

On your first appointment, please fill out the age appropriate New Patient form plus the Pain Disability and Functional Assessment forms found above.

Optilife Chiropractic in Tampa accepts most major insurance companies Including:

Please call if your insurance plan is not listed below.  We can call to verify your insurance to see if we are in network. 

Learn more about all of our insurance partners and policies.

What to Expect from Optilife

Chiropractic Doctors & Staff

Evaluation and Treatment Plans

During your first visit, your intake paperwork and medical history will be reviewed thoroughly by the chiropractor.  Based on your symptoms and history, they may decide xrays are warranted and will take the xrays in the office.  Additional diagnostics such as the Insights ICA and posture analysis may also be performed at no extra cost.  Once the Doctor has a clear understanding of your health and spinal alignment, she will go over the findings and perform the first adjustment.  She may also provide an additional therapies such as Cold Laser or STEM therapy.

A recommended treatment plan will be discussed and you may be provided with stretching and exercises to do at home between appointments. A follow up appointment will be set.   This is a great time to ask any questions that you may have about your treatment options and plan.

Chiropractic Maintenance

Optilife and the Chiropractic community strongly suggest that you get rountine monthly chiropractic adjustments.  Don’t wait until you are in pain, prevent pain and related illnesses by getting adjusted at least once a month.

Maintain a Healthy Immune System

Maintaing a strong and healthy immune system is the best way to fight disease and live a healthy lifestye.  Chiropractic adjustments have been proven to improve our bodies immune function.  Be sure to eat healthy, exercise 30 minutes a day five times a week and schedule your chiropractic adjustment.

The Importance of Chiropractic Care During Pregnancy

Dr. Rachel Wroblewski has extensive specialized training in prenatal care.  Chiropractic adjustments will help with the “normal” back-aches and pains associated with pregnancy or the post-natal period.  It will also help improve sleep and wellness during your pregnancy.   We use specialized approaches for pregnant women, including the Webster technique that was specifically designed to help mothers through their pregnancy.

Massage Therapy

Maintaing strong flexible muscles is key to reducing inflamation, supporting proper alignment and reducing the aches and pains of daily life.  Book your massage appointment today and start feeling better!

Chiropractic Care for Auto Accident Victims

If you have been in an auto accident, chances are you have sustained some trauma to your skeletal system. Even if you are not feeling direct pain your spinal column may be compromised.  We recommend a complete chiropratic exam and xrays within a few days of an auto accident.

What You Need to Know About Your Appointment

During your first appointment, our doctors will listen to your description of current health condition along with reviewing your intake paperwork and getting a family history.  Our goal is to get to know you and get a good understanding of your lifestyle and overall health.  Serveral diagnostic tests will be administered, covered by the initial exam fee, to get a complete picture of how well your nervous and skeletal systems are functioning.  Each patient is different.  We do not perform the same diagnostic tests on everyone.

Unless otherwise indicated, Optilife Chiropractors will adjust you on your first visit and may provide additional therapies.  Our goal is to reduce your pain level and improve overall health after the first visit.


New Patient Form

Please be sure to accurately list all areas where you are experiencing pain.


Your Medical History

Be sure to include any past accidents or trauma, operations or therapies.


Insurance Information and Drivers License

If you have insurance, be sure to bring your current insurance card and photo id such as a drivers license.

New Patient Request Form

We will respond within one business day.  For faster service please call 813 926-9500.

What days of the week are you available

15 + 9 =

Helping You Live Your Optimal Life

Same Day Appointments are Often Available.

(813) 926-9500

Fax: (813) 433-5517


8377 Gunn Highway, Tampa, Fl 33626