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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.

New Patient Forms - Required

We know that it is detailed, but if you take the time to complete the New Patient Form in its entirety (and in the comfort of your own home), it will expedite your first visit in the office and enable us serve you better!

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 Forms: 

New Patient Forms


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

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