Patient Forms

If you do not have access to a printer, you may fill out the paperwork at your first appointment or online. 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 Chrio Patient Paperwork PDF

or fill it out online, no need to print:

New Chrio Patient Paperwork Online

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

Lipo Light

Email us at to get Lipo Light forms.

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

Food Diary

Toxicity Questionaire

To fill out a Symptom Survey Email us at


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