INTEGRATED CHIROPRACTIC -BOCA RATON

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Patient Intake Form

Welcome to our online Patient Digital Intake Form. The information you provide is instantly sent to our office. This will speed up your initial office visit and allow us to better serve your healthcare needs. If you are unsure of an answer, simply skip that question, and the doctor will discuss this during your consultation. All information is encrypted and HIPAA compliant for your secure health records.

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