Patient Forms

If you do not have access to a printer, you may fill out the paperwork at your first appointment. Please arrive at least 15 minutes early if you do not have your paper work filled out ahead of time.


New Patient Forms

Please print, fill out, and bring with you to your first appointment:

New Patient Paperwork

Please call (801) 784-7104 if you have any questions while filling out paperwork.


Upon the Doctor's request, you may be asked to fill out:

Food Diary

Toxicity Questionaire

Symptom Survey

Dr. Richard Sarchenko, I.H.S.

Salt Valley Chiropractic & Nutrition Clinic


872 Heritage Blvd., Suite 130 A, Layton UT. 84041.


We look forward to seeing you there. 



or email us at