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Diversified 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 Patient Health History Form - 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!

Download & Print Form


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our chiropractic office. You can print the form out and bring it in to our office during your next visit with our chiropractor, or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form



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Hope for Healing

No matter what level of pain you are experiencing, Dr. Neil Jackson wants you to know that no issue is too big and that you can find relief. Many of his patients come to him with complex or chronic issues. When patients make a commitment to their health and overall well-being, Dr. Jackson is able to help them overcome spinal issues they thought they would have to live with forever.

You won’t get a prescription and head home as you might elsewhere, and life-changing results don’t necessarily happen overnight. Chiropractic can do amazing things for people. Many of our patients have overcome debilitating conditions and found a level of well-being they never imagined.

THIS ---->https://shawchiropracticcocom.chiromatrixbase.com/online-forms.html

Office Hours

DayMorningAfternoon
Monday7 - 11:301:30 - 5:30
Tuesday7 - 11:301:30 - 5:30
Wednesday7 - 11:301:30 - 5:30
ThursdayClosed
Friday7 - 12:00
SaturdayClosed
SundayClosed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
7 - 11:30 7 - 11:30 7 - 11:30 Closed 7 - 12:00 Closed Closed
1:30 - 5:30 1:30 - 5:30 1:30 - 5:30

Testimonial

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