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Online Forms

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

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!

Download & Print Form


Pediatric New Patient Form - Required

This form lets us know the history and current state of your child's health so that we can better assist wellness concerns and issues that needs to be addressed. 

Download & Print Form


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form


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


Download the Free AdobeReader®

Office Hours

DAY OPEN OPEN
MONDAY 8am - 12pm 2pm - 6pm
TUESDAY 7am - 11am 12pm - 3pm
WEDNESDAY 8am - 12pm 2pm - 6pm
THURSDAY 8am - 12pm
FRIDAY 8am - 12pm 2pm - 6pm
SATURDAY
SUNDAY