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Blaine Family 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.

New Massage Client Forms- Required

Massage Intake Form

HIPPA Form

Client Bill of Rights

Minor Release Massage Form - (For Clients Under 18 years of Age)


Chiro. New Patient Forms for Children and Adolescents - Required

Child and Adolescent Intro. and Consultation

Family Health History

Informed Consent

Consent to Treat a Minor

HIPPA


Chiro. New Patient Forms for Adults - Required

Adult Intro. and Consultation

Family Health History

Informed Consent

HIPPA



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THIS ---->https://blainefamilychiropractic.com/online-forms.html

Hours

DayMorningAfternoon
Monday6:30am - 11:00am2:00pm - 6:30pm
Tuesday11:00am - 6:30pm
Wednesday8:00am - 11:00am2:00pm - 6:30pm
Thursday11:00am - 6:30pm
Friday8:00am - 2:00pm
SaturdayBy AppointmentClosed
SundayClosedClosed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
6:30am - 11:00am 11:00am - 6:30pm 8:00am - 11:00am 11:00am - 6:30pm 8:00am - 2:00pm By Appointment Closed
2:00pm - 6:30pm 2:00pm - 6:30pm Closed Closed

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