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New Patient Paperwork

We offer our paperwork online so you can complete it in the convenience of your own home.

Chiropractic Wellness Health History

This lets us know what’s happened, but perhaps more important, where do you want to take your health?  When you are done filling out the paperwork, you can email it to us at

Download & Print Form

Massage Therapy Health History

Ready for a massage? Complete this form to tell our therapists about any issues or goals.


Free AdobeReader®

Our New Patient form is a PDF document file. If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.

Call our Midlothian chiropractic office now to schedule an appointment!

Midlothian Chiropractor | (804) 745-8745

Proudly Serving the Midlothian and Chesterfield communities.