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visit_forms.pngDunkirk Chiropractic and Wellness Center and Waldorf Chiropractic and Injury Center offers our first visit forms here so you can complete them in the convenience of your own home or office.

  • Save time
  • More convenient
  • More comfortable

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New Patient Health History & Wellness Assesment Form
Required for your first visit


Download & Print Patient History Form

Wellness Assessment Form


om1.jpgInstructions:

  • Download the necessary forms, print them out and fill in the required information.
  • Fax us your printed and completed forms or bring them with you to your appointment.
  • If you do not already have AdobeReader® installed on your computer, Click Here to download.

Questions? Contact us at 410-286-3335 or 240-754-7130 or 



Download the Free AdobeReader®

Exclusive Offer

New patients receive a
FREE BODY COMPOSITION ANALYSIS
after their first visit.

Sign-up using the form or call us at 410-286-3335 to take advantage of this exclusive offer.

Office Hours

Day
Monday9am - 12pm3pm - 6:30pm
Tuesday9am - 12pm3pm - 6:30pm
Wednesday9am - 12pm3pm - 6:30pm
Thursday9am - 12pm3pm - 6:30pm
Friday9am - 12pm3pm - 6:30pm
Saturday9am - 12pm
SundayClosed
Day
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
9am - 12pm 9am - 12pm 9am - 12pm 9am - 12pm 9am - 12pm 9am - 12pm Closed
3pm - 6:30pm 3pm - 6:30pm 3pm - 6:30pm 3pm - 6:30pm 3pm - 6:30pm