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New Patient Forms

Click link below to get form in PDF format

Intake Form

Informed Consent Form

HIPPA Form

Financial Agreement Form

Office Polices Form

Contact Information

  • Chiropractic, Massage, Nutrition Inc.
  • 5836 Bellflower Blvd.
    Lakewood CA 90713
  • 562-461-3998

Office Hours

MON 10:00a – 1:00p | 3:00p – 7:00p
TUE 10:00a – 1:00p | 3:00p – 6:00p
WED 10:00a – 1:00p | 3:00p – 7:00p
THU 10:00a – 1:00p | 3:00p – 7:00p
FRI 10:00a – 1:00p | 3:00p – 6:00p
SAT 9:00a – 1:00p
SUN Closed

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