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New Patient Paperwork

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

  • All forms are PDF files. You will need AdobeReader® to view them...
  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

WHAT OUR PATIENTS SAY

“I have been so pleased with the disappearance of my allergies through chiropractic care. I have had allergy symptoms since childhood! Our whole family has been taken care of by Dr. Martines and all of our lives have been changed for the better.”

- Karen Hackett

“It`s critical as children grow to keep them on the path of health. Chiropractic has helped keep our children extremely healthy without the use of drugs, antibiotics, vaccines or over-the-counter medications.”

- Will Goulding

“Chiropractic helped me feel both physically and mentally better during my radiation treatments. I`m 70 years old and have been seeing a chiropractor since I was 5 years old. Chiropractic works!”

- Jerome Derus

Campbell Location

Los Gatos Location