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Online Forms

Chiropractic Health and Wellness offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, click here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form


Terms of Acceptance - Required

Information for us to know who we can talk to about personal information. (HIPPA)

Download & Print Form


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Contact Us to schedule your appointment

(740)335-0914

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Locations

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Office Hours

Our Regular Schedule

Chiropractic Health and Wellness

Monday:

7:00 am-12:00 pm

2:00 pm-6:00 pm

Tuesday:

7:00 am-12:00 pm

2:00 pm-6:00 pm

Wednesday:

7:00 am-12:00 pm

2:00 pm-6:00 pm

Thursday:

7:00 am-12:00 pm

Closed

Friday:

7:00 am-12:00 pm

2:00 pm-6:00 pm

Saturday:

Closed

Sunday:

Closed