Back In Motion Chiropractic and Sports Rehab

Patient Intake Form

Welcome to BACK IN MOTION CHIROPRACTIC AND SPORTS REHAB and our online Patient Intake Form. The information you fill in will be sent directly to our office, speeding up your office visit and allowing us to better serve your healthcare needs. NOTE: While selecting different areas of the body to be evaluated, please input your primary complaint area first, at the bottom of the page select DO YOU HAVE AN ADDITIONAL CONDITION? to input another complaint area. Any questions please call 503-524-9040.

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