Skocik Chiropractic

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Patient Intake Form

Welcome to our online Patient Intake Form. The information you fill in will be sent directly to our office, speeding up your office visit and allowing us to better serve your healthcare needs. When you arrive at the office you will need to complete our HIPAA Acknowledgement Form and Office Police. Based on your condition or nature of your injury you might have to complete additional paperwork.

Who are you?

Let's get started. Fill out the fields below to speed up your office visit.