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

  • 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.

New Patient Intake Form
Established Patient Intake Form
Authorization Form
Privacy Notice Form



Optional
Personal Injury Questionnaire
Workmans Compensation Form



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THIS ---->https://capitolchiropracticnet.chiromatrixbase.com/online-forms.html

Office Hours

DayMorningAfternoon
Monday8:00 - 12:002:00 - 5:30
Tuesday8:00 - 12:002:00 - 4:30
Wednesday8:00 - 12:002:00 - 5:30
Thursday8:00 - 12:002:00 - 4:30
Friday8:00 - 12:002:00 - 5:30
Saturday8:30 - 12:00Closed
SundayClosedClosed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8:00 - 12:00 8:00 - 12:00 8:00 - 12:00 8:00 - 12:00 8:00 - 12:00 8:30 - 12:00 Closed
2:00 - 5:30 2:00 - 4:30 2:00 - 5:30 2:00 - 4:30 2:00 - 5:30 Closed Closed

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