Online Forms

The Burt Clinic of Chiropractic offers our patient forms online so they can be completed in the convenience of your own home or office.  Please complete and submit new patient forms prior to your first appointment.  If you are not able to complete the online form in advance, please arrive 15 minutes early to complete all forms.  Both paper and electronic versions are available!



Electronic Intake Forms:
 

Adult Intake Form

Pediatric Intake Form (0-9 years old)

Automobile Accident Form

Update Form (>1 year since last visit)


Paper Forms: 

Adult Intake Form (Paper Version)



Locations

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Office Hours

Our Regular Schedule

Burt Clinic of Chiropractic

Monday:

9:00 am-12:00 pm

3:00 pm-7:00 pm

Tuesday:

9:00 am-12:00 pm

3:00 pm-7:00 pm

Wednesday:

9:00 am-12:00 pm

3:00 pm-6:00 pm

Thursday:

9:00 am-12:00 pm

3:00 pm-7:00 pm

Friday:

9:00 am-12:00 pm

3:00 pm-6:00 pm

Saturday:

8:00 am-12:00 pm

Sunday:

Closed