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Online Forms

Daniels Family Chiropractic offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, click here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

Please click below to fill out the Patient Intake Form and submit it online. (Make sure the form is completed in full by using any device except smartphones.)

Patient Intake Form

Please click below to download and print the HIPPA Form. (Complete this form and bring it with you at the time of your appointment)

HIPPA Form

Please click below to download and print the Financial Responsibility Form. (Complete this form and bring it with you at the time of your appointment)

Notification Of Financial Responsibility Form

Please click below to download and print the Informed Consent Form. (Complete this form and bring it with you at the time of your appointment)

Informed Consent Form



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Our Hours

Monday:

8:00 am-12:00 pm

2:00 pm-6:00 pm

Tuesday:

8:00 am-12:00 pm

2:00 pm-6:00 pm

Wednesday:

8:00 am-12:00 pm

2:00 pm-6:00 pm

Thursday:

Closed

Friday:

8:00 am-12:00 pm

2:00 pm-6:00 pm

Saturday:

8:00 am-10:00 am

Sunday:

Closed

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Don't Let Back Pain Get You Down This Summer; Chiropractic Can Help

Spending too much time on the couch due to back pain this summer? Chiropractic treatment could help you salvage your summer. ...

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Chiropractic Care for Osteoarthritis

Tired of living with osteoarthritis pain? Your chiropractor may be able to help. ...

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Myofascial Release

Not all pain is caused by obvious injuries like broken bones or cuts. Some pain may stem from the myofascial tissues. These tough membranes are wrapped around your muscles to provide support and connect them to other parts of the body. When myofascial tissue becomes stiff, it may restrict movement in ...

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Chiropractic and Headaches

Have headaches become an unwelcome part of your life? Chiropractic care may help you finally get rid of your pain. ...

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How to Make Sure Your Chiropractic Adjustment Lasts

A few surprisingly simple steps can help you maintain your chiropractic adjustment results longer. ...

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Chiropractic and Vertigo

Medication isn't the only solution if you suffer from vertigo. Chiropractic treatment may finally stop the spinning. ...

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The 3 Most Common Chiropractic Questions Answered

Looking for a natural way to treat pain? Chiropractic care offers an effective solution. ...

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How Chiropractic Care Can Help While Pregnant

Tired of pregnancy aches and pains? Chiropractic care can ease your symptoms naturally. ...

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How to Enjoy Summertime Activities Without Back Pain

Want to avoid an aching back this summer? Try a few of these suggestions. ...

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Winter Activities that Can Cause Pain and How to Prevent It

Do you know how to avoid winter aches and pains? ...

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