New Patient Paperwork

The New Patient Forms take an estimated 10-15 minutes to complete, unless you have a detailed health history.

At Chiropractic Health And Wellness Center, your first visit will begin with a warm smile and personal greeting! If you would like to come to our office as a new patient, please fill out the New Patient Forms.

These forms are our first insight to your overall health and spinal condition and are vital for initiating your care. Please provide us with the best phone numbers and contact information. We ask that you plan to be in our office a total of 90 minutes for your first in office visit.

  • New Patient Form

    Click to Complete

  • HIPPA - Read Only

    Click to Read

OFFICE HOURS


Monday
7:30am - 12:30pm
2:00pm - 6:00pm


Tuesday
1:30pm - 6:00pm


Wednesday
7:30am - 12:30pm
2:00pm - 6:00pm


Thursday
1:30pm - 6:00pm


Friday
7:30am - 12:00pm


Saturday & Sunday
Closed

Chiropractic Health and Wellness Center

5412 Glenside Dr Suite E
Richmond, VA 23228

(804) 359-6999