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Burgess Chiropractic & Acupuncture Clinic offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic 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!

Welcome Patient Form 1   Welcome Patient Form 2



Download the Free AdobeReader®

Exclusive Offer

New patients receive 15% OFF* first visit.
*due to federal regulations, some restrictions may apply
Sign-up using the form or call us at (256) 237-9251 to take advantage of this exclusive offer.

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

Office Hours

DayMorningAfternoon
Monday7:30 - 112 - 5:30
Tuesday7:30 - 112 - 5:30
Wednesday7:30 - 11closed
Thursday7:30 - 112 - 5:30
Fridayclosedclosed
Saturdayclosedclosed
Sundayclosedclosed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
7:30 - 11 7:30 - 11 7:30 - 11 7:30 - 11 closed closed closed
2 - 5:30 2 - 5:30 closed 2 - 5:30 closed closed closed

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