Accessibility View Close toolbar

Online Forms

At Chiropractic Health And Wellness Center, your first visit will begin with a warm smile and personal greeting!

If you would like to come to our office as a new patient, please fill out the New Patient Forms. There is no need to call or inform our office, unless you have additional questions. The New Patient Forms take an estimated 10-15 minutes to complete, unless you have a detailed health history. The forms are not always compatible with Internet Explorer. Please fill out the forms using a different browser.

  • If you are 65 or older or have Medicare, please email our new patient coordinator at [email protected] BEFORE filling out the online New patient forms. In your email, please include your name and best telephone number to reach you. We will contact you regarding Medicare and our office.  
  • To see what insurances are considered in-network in our office click HERE:

Please be aware that you will not be contacted to schedule your new patient appointment unless we receive your completed New Patient Forms.  This occurs when you click the “SUBMIT” button at the end of the New Patient Forms. Please be sure to fill out your insurance information on the paperwork as well. Once you submit your forms, our New Patient Coordinator will call you, usually within 24 business hours, to discuss your insurance benefits and schedule your first appointment. 

To see our New Patient Appointment Times, click HERE.

We have provided our New Patient Forms for your convenience. These forms are our first insight to your overall health and spinal condition and are vital for initiating your care. Please provide us with the best phone numbers and contact information. We ask that you plan to be in our office a total of two hours for your first in office visit.

If for some reason you will not be able to make your appointment, we request you provide at least 12 hours notice so that another person in need of the doctor's time may be helped.  

Please click the link below to fill out your New Patient Forms: 

These forms are best completed on a desktop or laptop computer. You may experience problems submitting the forms if completed on a tablet or smartphone.  

Please click the link below to fill out your New Patient Paperwork: 

New Patient Forms


HIPPA

Please read the Patient Privacy Act. The forms to sign are included with the New Patient Forms link.

Download & Read - Do Not Print

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.

Location

Find us on the map

Office Hours

Our Regular Schedule

Monday:

2:00 pm-6:00 pm

Tuesday:

1:00 pm-6:00 pm

Wednesday:

7:30 am-12:30 pm

Thursday:

1:00 pm-6:00 pm

Friday:

7:30 am-12:00 pm

Saturday:

Closed

Sunday:

Closed

Testimonials

Reviews By Our Satisfied Patients

  • "I can't believe how professional, efficient, and effective the entire staff is at CHAWC. I am out and on my way to work in a short time, while achieving maximum results."
    Jodie Richmond, VA
  • "I have suffered from lower back and sciatica pain for over two years now. Prior to my visit to this practice, I have been x-rayed, tested, MRI, countless specialists visits and not to mention the costs associated with all of that. I have been in chiropractors' offices before and they usually adjust my back and the pain decrease for a day or two but never goes away. Dr. Cally was thorough, knowledgeable in her specialty, and kind. Although, I was skeptical at first but, Dr. Cally's knowledge put me at ease. Needless to say, now I am pain free. Not only she is good with her patients but once you walk-in that office you will feel the good vibe from her staff (happy employee means happy customer), which tells me she is treating her staff good as well. Thank you, Dr. Cally for all you do. You and your practice are hard to find these days. Keep up the good work."
    Dr. Beygatt, PhD
  • "Dr. Jo has been such a blessing and resource for my health and my back. I have been doing chiropractic for about 15 years, and Dr. Jo's treatments and home therapies have seriously changed my life and my back and neck in the past year. I am in awe of how much better I feel overall and so appreciate their dedication to my health and well-being!"
    Joy
  • "Dr. Cally Parks has so greatly impacted my overall well being! Her thorough and compassionate care has lead me to feeling my best. I highly recommend her to anyone with any back or hip pain."
    Megan
  • "I can't say enough good things about Dr. Jo and the rest of the staff. I've never enjoyed a medical treatment so much. Every time I come in, I feel like I'm seeing good friends. Chiropractic Care has changed my life for the better, and I believe the philosophy at CHAWC has been key to my success. I have recommended CHAWC to many and will continue to do so!"
    Sunni
  • "I am very impressed with the quality of care and knowledge of Drs. in this clinic. My quality of life has improved drastically and I am able to do things now that I have not in a few years. Dr. Cally and Dr. Jo have made a difference for me. Laura and Julie are so welcoming, as well as willing to work with your schedule so you can reach your health goals. Thank you Chiropractic Health and Wellness Center!!!"
    Ashley