Online Forms

Active Life 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.

New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form

ALC Hippa Form

Download & Print Form

ALC History Form

Download & Print Form

ALC Informed Consent

Download & Print Form

ALC Chiropractic Fee Schedule

Download & Print Form


Download the Free Adobe Reader®

Location

Office Hours

Monday

Closed

Tuesday

10:00 am - 1:00 pm

2:30 pm - 6:00 pm

Wednesday

9:30 am - 1:00 pm

Thursday

10:00 am - 1:00 pm

2:30 pm - 6:00 pm

Friday

8:00 am - 1:00 pm

Saturday

10:00 am - 1:00 pm

Sunday

Closed

Monday
Closed
Tuesday
10:00 am - 1:00 pm 2:30 pm - 6:00 pm
Wednesday
9:30 am - 1:00 pm
Thursday
10:00 am - 1:00 pm 2:30 pm - 6:00 pm
Friday
8:00 am - 1:00 pm
Saturday
10:00 am - 1:00 pm
Sunday
Closed