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Health & Wellness Doctors

New Patient Intake Online Submission Form

We are currently offering an online Initial Intake Portal for New Patients.

As a new patient we require certain personal and health information to ensure that you receive the best possible care.

You have the option to complete the paperless form to the right or print off the forms below and bring them with you to you first appointment.  

What Service are you Interested In?
I have read and agree to the Chiropractic Consent Form on this website
I have read and consent to the Acupuncture Consent Form on this website
I have reviewed the COVID 19 Policies and Clinic Procedures Form on this Website
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Thank you for contacting us. We will get back to you as soon as possible