Smith Chiropractic

(910) 642-2481

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    • Home
    • Services
    • SoftWave Therapy
    • About Us
    • Patient Forms
    • Contact Us

(910) 642-2481

Smith Chiropractic
  • Home
  • Services
  • SoftWave Therapy
  • About Us
  • Patient Forms
  • Contact Us

New patient Packet

TO SUBMIT YOUR NEW PATIENT PACKET ELECTRONICALLY CALL (910) 642-2481 AND WE WILL SEND YOU A LINK BY E-MAIL.  

You may also download and fill out these forms prior to your appointment and bring them with you to your appointment.  Either way will save you some time!!!  You will need to fill out a New Patient Packet AND one of the complaint forms. If you need help with or have questions about the forms please contact us.  We are here to help !!!

New Patient Packet (All Patients) (docx)

Download

New Patient Complaint Form (Insurance, Cash, SoftWave) (pdf)

Download

New Patient Complaint Accident / Injury Form (Auto Accidents, Work Comp Claims) (pdf)

Download

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Joint Pain ? Get SoftWave! $49 Initial Consult & Treatment

Includes:  Consultation, Problem Specific Exam, Radiology Review, Initial Treatment, and Treatment Plan Recommendation

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