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. Download and Print out the Administration Forms at this link listed below.  Fill them out and sign and bring them in with you or we can have you fill them out in the office before you appointment,  If you choose to fill them out in the office give yourself at least 20 minutes BEFORE your appointment time to fill out all the forms completely as they are thorough.
    2. Now fill out your patient forms online by following this link to our New Patient Form site.
    3. After you fill out your 3 forms online and your Admin Forms that you printed out at home and will bring with you,  you should call the office to choose your appointment day and time, 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