Patient Forms

Becoming a Patient is Simple

First visit, New Patient Exam is $250.  Must be prepaid over the phone when you make your appointment.

The exam does not include any treatment but you can be adjusted if the doctor feels it is appropriate on you exam day for the usual adjustment/therapy fee in addition the exam fee.
Getting well with chiropractic and nutritional support has never been so simple
    1. IF YOU DO NOT HAVE PRINTER THEN SKIP THIS STEP AND GO TO #2 BELOW NOW.   IF you have a PRINTER then Download and print out the Administration Forms by clicking on the highlighted link.  Make sure they are completely filled out and signed and bring them in with you on your appointment.
    2. Click HERE to to fill out your Health History Forms online. New Patient Form site.
    3. After you fill out your 3 forms online you should call the office to arrange your first appointment for your exam with the doctor. Call now 434-481-2012
      • Come in 15 minutes early for your first appointment

If you are a TeleHealth Patient (online video consultation appointments) ALSO fill out the TeleHealth Consent Form here.

Other Patient Forms and Downloads