Patient Forms

New Patient Intake Application (Click Below)

                                                                                             https://www.mychirotouch.com/patientintake/?clientid=WCC0067

Shoulder Pain Disability Questionnaire.pdf

Revised Oswestry Low Back Pain Disability Questionnaire.pdf

Neck Pain Disability Questionnaire.pdf

Headaches and Chiropractic.pdf

HIPAA Privacy Notice.pdf

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Our Location

83 Bangor Junction Rd

Bangor, PA 18013 United States

610-588-7640