Online Forms

Life Chiropractic & Wellness Center 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.

Patient Intake Form 

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!

Fill Out Online

New Patient Application

Download & Print Form


Download the Free Adobe Reader®

Location

Office Hours

Monday

9:00 am - 11:00 am

3:00 pm - 6:00 pm

Tuesday

9:00 am - 11:00 am

3:00 pm - 6:00 pm

Wednesday

9:00 am - 11:00 am

3:00 pm - 6:00 pm

Thursday

9:00 am - 11:00 am

3:00 pm - 6:00 pm

Friday

Closed

Saturday

Closed

Sunday

Closed

Monday
9:00 am - 11:00 am 3:00 pm - 6:00 pm
Tuesday
9:00 am - 11:00 am 3:00 pm - 6:00 pm
Wednesday
9:00 am - 11:00 am 3:00 pm - 6:00 pm
Thursday
9:00 am - 11:00 am 3:00 pm - 6:00 pm
Friday
Closed
Saturday
Closed
Sunday
Closed