Online Forms

Midtown Clinic of Chiropractic offers our patient form(s) online so they can be completed in the convenience of your own home or office.

Click here to fill out our New Patient form on your device!
Forms image

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!

Accident Form

This form is to be filled out regarding any accidents in order for us to have a clear understanding on what we can do to assist you!

Pediatric Consultation

Having trouble reading the forms?

To learn more about our payment options
for chiropractic and wellness care

you can call our Lantana and West Palm chiropractic offices directly at (561) 533-3884 and one of our friendly staff will be happy to answer all your questions.

What’s Next?

By now you know the details of your first visit and what we can do for you. Here is more useful information to help you guide you to a path of better health.

  1. Your First Visit
  2. Learn more about the 4 Phases of Treatment
  3. Meet our team
  4. View our payment options

If you still have questions or want to start today you can call us at (561)533-3884 or click here

Call to action background
Scroll to Top