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Back In Action Chiropractic offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic 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.

Adult Patient Forms

Pediatric Patient Forms

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Exclusive Offer

Consultation, Neurological Evaluation, Orthopedic Examination, and Doctor's Report of Findings for only $20

Offer may not be valid for Medicare/Medicaid or Personal Injury  


Office Hours

Day Morning Afternoon
Monday 10am - 1pm 3pm - 7pm
Tuesday 3pm - 7pm
Wednesday 10am - 1pm 3pm - 5pm
Thursday 10am - 1pm 3pm - 7pm