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Chiropractic and Acupuncture 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 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!

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Hours of Operation

Mon 8am - 7pm
Tue 8am - 7pm
Wed 8am - 7pm
Thu 8am - 7pm
Fri 8am - 7pm
Sat By Appointment
Sun 8am - 1pm

Call Us:
813-835-4488
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Appt.

3325 W Gandy Blvd
Tampa, St Petersburg, Clearwater, Orlando, Pinellas Park, FL 33611

Tel:  813-835-4488
Fax: 800-518-9398

Email: Chiropractic and Acupuncture

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