NUTRITIONAL CARE FORMS
BOTH forms are REQUIRED:
** New
patient (nutritional) PRINT and COMPLETE
** Symptom Survey PRINT and COMPLETE
These forms are for structural care:
Printed form:New
patient (CHIROPRACTIC)
Or Online form:
https://www.mychirotouch.com/patientintake/?clientid=LWC0011
and/or
Please complete the forms in black ink.
You
may return these forms by fax: (864) 246-5569
OR simply bring with you.
NOW SERVING YOU IN TWO LOCATIONS IN THE UPSTATE!
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