Optilife Patient Forms



Welcome to our patient forms and information center. No matter your need, our friendly staff will get it done.  See below for links to schedule an appointment online and general information.

Our flexible scheduling is designed to accommodate your schedule.  In addition, 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, the chiropractor will review your intake paperwork and medical history thoroughly. Then, based on your symptoms and history, they may decide that xrays are warranted and will take the x-rays in the office. Additional diagnostics, such as the Insights ICA and posture analysis, may also be performed at no extra cost. Once the doctor understands your health and spinal alignment, she will review the findings and complete the first adjustment. She may also provide additional therapies such as Cold Laser or STEM therapy.
A recommended treatment plan will be discussed, and you may be provided stretching and exercises 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” backaches and pains associated with pregnancy or the post-natal period.  It will also help improve sleep and wellness during your pregnancy.   In addition, we use specialized approaches for pregnant women, including the Webster technique, 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, you have likely sustained some trauma to your skeletal system. Your spinal column may be compromised even if you are not feeling direct pain.  We recommend a complete chiropractic exam and x-rays 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 your current health condition, review your intake paperwork, and get a family history. Our goal is to get to know you and understand your lifestyle and overall health. Several 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.
Optilife Chiropractors will adjust you on your first visit and may provide additional therapies unless otherwise indicated. After the first visit, we aim to reduce your pain level and improve your overall health.


New Patient Form

Please fill out the new patient form online and 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.

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