New Patient Paperwork

Long Chiropractic offers our patient form(s) online so they can be completed 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 them with you to your appointment.
  • ALL new patients must fill out the New Patient Paperwork.
  • Additional forms are required if one of the following pertain to you.

OFFICE HOURS


Monday
8:00am - 12:00pm
2:00pm - 5:00pm


Tuesday
8:00am - 12:00pm
2:00pm - 5:00pm


Wednesday
8:00am - 12:00pm
2:00pm - 5:00pm


Thursday
8:00am - 12:00pm
2:00pm - 5:00pm


Friday
Closed


Saturday
Closed

Long Chiropractic
15 N 200 W
Hurricane, UT 84737
Phone: (435) 635-3828
Fax: (435) 635-4433