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Online Forms

City Center Chiropractic offers our patient forms online so they can be completed in the convenience of your own home or office.

  • If you do not already have AdobeReaderĀ® installed on your computer, Click Here to download.
  • Download appropriate forms, print them out and fill in the required information.
    • New patients: the New Patient Information form and Function Questionnaires
    • Auto accident: the above forms plus Auto Accident and Power of Attorney forms
    • Worker's compensation: New Patient Information, Function Questionnaires, and you should expect additional paperwork upon arrival at the clinic.
  • Bring the forms with you to your appointment, along with photo identification and your insurance card(s).


New Patient Information

This gives us some basic information about you, including your contact information and medical history. It also contains a basic sketch of our financial policy, and your signature is required in order to be seen as a patient.

Download & Print Form

Function Questionnaires

These forms are used to track the progress of your functional capabilities, and can help us set and follow your goals to get the most out of your treatment.

Download & Print Forms

Personal Injury Forms

If you have been involved in an auto accident, we ask that you also bring in the following forms.

Auto Accident Questionnaire

Power of Attorney (for checks)

Contact Us

Location

Find us on the map

Office Hours

Our Regular Schedule

Primary Location

Monday:

8:00 am-1:00 pm

3:00 pm-5:30 pm

Tuesday:

3:00 pm-5:30 pm

Wednesday:

8:00 am-1:00 pm

3:00 pm-5:30 pm

Thursday:

8:00 am-1:00 pm

Friday:

8:00 am-1:00 pm

3:00 pm-5:30 pm

Saturday:

Closed

Sunday:

Closed