Online Forms

Download & Print FormDr. Connie's Chiropractic and Acupuncture Center offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic 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.

Patient Health History Form

Download & Print Form


Informed Consent Form

Download & Print Form


Patient Health Information Consent Form

Download & Print Form


Stress Assessment  

Download & Print Form


Toxicity Questionnaire  

Download & Print Form


Cancellation Policy  

Download & Print Form



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Contact Us

Location

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Office Hours

Our Regular Schedule

Monday:

Afternoons by Appointment Only

Tuesday:

8:30 am - 12:00 pm

2:00 pm - 4:30 pm

Wednesday:

Closed

1:00 pm - 6:00 pm

Thursday:

9:00 am - 12:00 pm

2:00 pm - 6:00 pm

Friday:

9:00 am - 12:00 pm

2:00 pm - 4:30 pm

Saturday:

Closed

Closed

Sunday:

Closed

Closed