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Choice Chiropractic and Wellness 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 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!

New_Patient_Information.pdf

Patient_Health_History.pdf

Other Forms:
 

HIPAA Form
Informed Consent Form

Auto Accident Questionnaire.pdf



Download the Free AdobeReader®

Sign up using the form below or call (480) 888-7383 to make an appointment.

THIS ---->https://mychoicechiro.chiromatrixbase.com/new-patient-center/online-forms.html

Office Hours

DayMorningAfternoon
Monday8:00am - 12:00pm2:00pm - 6:00 pm
Tuesday8:00am - 12:00pm2:00pm - 6:00 pm
Wednesday8:00am - 12:00pm2:00pm - 6:00 pm
Thursday8:00am - 12:00pm2:00pm - 6:00 pm
Friday8:00am - 12:00pmClosed
SaturdayBy AppointmentClosed
SundayClosedClosed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8:00am - 12:00pm 8:00am - 12:00pm 8:00am - 12:00pm 8:00am - 12:00pm 8:00am - 12:00pm By Appointment Closed
2:00pm - 6:00 pm 2:00pm - 6:00 pm 2:00pm - 6:00 pm 2:00pm - 6:00 pm Closed Closed Closed

Testimonial

Dr. Shiflet, I just wanted to thank you for everything you have done for my health. After 3 years of being at my worst healthwise, you have brought me to my best and I appreciate it more than words can say. You care about your patients and that is what makes you a wonderful doctor. Thanks again so much!!!

Natalie
San Tan Valley, AZ

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