Back 2 Back Chiropractic

Patient Intake Form

Welcome to Back 2 Back Chiropractic’s online Patient Intake Form. The information you provide in this form will be sent directly to our office. We look forward to meeting you and becoming part of your healthcare team. NOTE: If you are experiencing more than one area of complaint (ex: neck AND low back), our intake form will ask you to fully describe each complaint separately. After completing details on your primary complaint, select "yes" when asked if you have an additional condition.

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