Now Offering Lunch Appointments!
Phone: (386) 337-3884

Corrective Chiropractic care for spinal misalignments, postural issues, and sports injuries.

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We offer a wide range of weight management services and solutions.

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A non-surgical, drug-free approach to severe neck and back pain.

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Forms

Please submit your forms via one of the following three methods. If you do not have access to a printer please use method 1. If you are on a mobile device, download and editing abilities may be limited depending on available apps so you may need to access forms from a desktop.

1. Download / Save, Complete and Then Email

  • Click on the form
  • Download the form by clicking on the download or save icon from your browser
  • Locate the form in your computer and open it. (Adobe Acrobate Reader is required to view and fill out forms. This is available as a free download by clicking here.)
  • Fill in the form in Adobe Acrobat Reader.
  • After completing your form, save it back to your computer
  • Come back to this page and fill in the form below:

OR

2. Open in Browser (Chrome, Firefox, etc), Complete and Print to Bring In

  • Click on the form (if you are unable to open the document, download the free Adobe Acrobat Reader by clicking here)
  • Fill in the document
  • Print out the completed form and bring it to your first office visit.

OR

3. Print Out and Complete by Hand to Bring In

  • Click on the form (if you are unable to open the document, download the free Adobe Acrobat Reader by clicking here)
  • Print out the form using your browser's print command
  • Complete the form and bring it to your first office visit




Disclaimer

DeLand Chiropractic & Spinal Decompression complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. DeLand Chiropractic & Spinal Decompression does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.