Online Forms

The Burt Clinic of Chiropractic offers our patient forms online so they can be completed in the convenience of your own home or office. Please download and print our patient health history form.


New Patient Health History Form

  • This lets us know the history and current state of your health. What questions, concerns, and goals regarding wellness can we help you with? Let us know!
  • Download the necessary form(s), print it out and fill in the required information.
  • Bring your completed form with you to your first appointment.



    Locations

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    Office Hours

    Our Regular Schedule

    Burt Clinic of Chiropractic

    Monday:

    9:00 am-12:00 pm

    3:00 pm-7:00 pm

    Tuesday:

    9:00 am-12:00 pm

    3:00 pm-7:00 pm

    Wednesday:

    9:00 am-12:00 pm

    3:00 pm-6:00 pm

    Thursday:

    9:00 am-12:00 pm

    3:00 pm-7:00 pm

    Friday:

    9:00 am-12:00 pm

    3:00 pm-6:00 pm

    Saturday:

    8:00 am-12:00 pm

    Sunday:

    Closed