Back to Health is an affiliate of The Wellness Way

New Patient Paperwork

Thank you for considering Back To Health Chiropractic – Let’s get started!

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

Step 1

Complete the Health History Questionnaire. Once you have completed this form, click the Submit button and it will be electronically sent to us.

Health History Questionnaire

Attention Parents/Guardians: If you have a child age 4 or under, you will need to print out and complete the Pediatric History Form and not the Health History Questionnaire listed above. Bring this form with you to the office for your first appointment!

Pediatric History

Step 2

Print out and complete the Signature Pages. Bring these forms with you to the office for your first appointment!

Signature Pages

Office Hours

Monday
7am-11am, 2pm-6pm

Tuesday
7am-10am, 2pm-6pm

Wednesday
8am-11am

Thursday
7am-11am, 2pm-6pm

Friday
7am-11am

Saturday
Closed

Sunday
Closed

Back to Health Chiropractic