New Patient Intake Form

Chiropractic
45 minute Initial Chiropractic Appointment $150
30 minute Chiropractic Appointment $100
15 minute Chiropractic Appointment $75

Orthotics $500

Massage Therapy
30 minute Appointment $65
45 minute Appointment $85
60 minute Appointment $100
90 minute Appointment $165

Acupuncture
75 minute Initial Acupuncture Appointment $150
60 minute Acupuncture Appointment $100

Reflexology
60 minute Appointment $100

New Patient Intake Form

New Patient Intake Form

Emergency Contact Information

Health Information

Insurance Information

Credit Card Information
We process all payments and co-pays not covered by your health insurance through your credit card

Reason for Today's Appointment

Health History

Present and Past Health Issues

Please indicate and provide a brief description of any present or past health issue, condition or symptom(s).

Family Health History

New Patient Intake Form

New Patient Intake Form

Emergency Contact Information

Health Information

Insurance Information

Credit Card InformationWe process all payments and co-pays not covered by your health insurance through your credit card

Reason for Today's Appointment

Health History

Present and Past Health Issues

Please indicate and provide a brief description of any present or past health issue, condition or symptom(s).

Family Health History

Credit Card Information
We process all payments and co-pays not covered by your health insurance through your credit card