Online Forms

Back in Motion Chiropractic & Rehabilitation 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



Download the Free AdobeReader®

Location

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Office Hours

Our Regular Schedule

Monday:

9:00 am-5:30 pm

Tuesday:

12:00 pm-6:00 pm

Wednesday:

9:00 am-5:30 pm

Thursday:

9:00 am-6:00 pm

Friday:

9:00 am-4:00 pm

Saturday:

By Appointment

Sunday:

Closed

Testimonials

Reviews By Our Satisfied Patients

  • "I was born with hip dysplasia which made my legs uneven. I have dealt with this issue for my whole life. It became worse when I decided to become a surgical nurse and am on my feet all the time at work. I finally decided to see Dr. Floarke when the pain became unbearable. She is a miracle worker!!! After seeing her just a few times, I was able to work my long hours without having to deal with my day to day pain!! She also fixed issues in my shoulder I sustained from playing softball for many years of my life. I recommend Dr. Floarke very highly to anyone who is needing and considering chiropractic and rehabilitation work!!"
    Jill Steele