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Online Forms

First Choice Chiropractic Injury Wellness Center offers our patient form(s) online so they can be completed it in the convenience of your own home or 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 Patient Forms - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Please download and print the following forms:

WELCOME FORM

RECEIPT OF PRIVACY PRACTICES

FINANCIAL POLICY

CONSENT TO TREAT

IF YOU HAVE BEEN IN AN AUTO ACCIDENT PLEASE PRINT THE FOLLOWING FORMS ALSO:

AUTO ACCIDENT FORM


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Office Hours

Our Regular Schedule

Clearwater Office

Monday:

9:00am - 12:00pm

1:00pm - 7:00pm

Tuesday:

9:00am - 12:00pm

1:00pm - 5:30pm

Wednesday:

9:00am - 12:00pm

1:00pm - 5:30pm

Thursday:

9:00am - 12:00pm

1:00pm - 7:00pm

Friday:

9:00am - 12:00pm

1:00pm - 5:30pm

Saturday:

9:00am - 12:00pm

Closed

Sunday:

Closed