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chiropractic forms for new patientsThe below forms are for new chiropractic patients and can be filled out online, printed and brought into our office during your first office visit. If you have any questions, please feel free to contact us.


 

 



New Patient Registration Form

New Patient Vehicle Accident Form

Female Consent Form to X-ray

 

You can print out these forms and bring to our office on your first visit.  If you print out the forms, please arrive at least 15 minutes early for your initial visit.

 

If you would like to submit these forms via email, follow these steps:
1. Open the form and fill it out.
2. Click "file" and then "save as" and save the .pdf document to your desktop.
3. Click the "submit forms" link on the top navigation menu and follow the steps on that page to submit the document.

 

Bailey Chiropractic Centre
2415 Penny Road, Suite 202
High Point, NC 27265
Phone: (336) 889-8584
Fax: (336) 889-7740

Chiropractor Hours

Monday - Friday
7:00am - 11:00am
1:00 - 5:00pm

Why Choose Us?

Most insurance carriers cover chiropractic care.  We will be happy to file your insurance for you.