Accessibility View Close toolbar

Online Forms

New Patient Health History Intake

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? ***IMPORTANT- you MUST click the "submit" button upon completion of your new patient intake forms to be securely transferred to our office.

This is the URL to your New Patient Intake Web Page:
https://www.mychirotouch.com/patientintake/?clientid=UHC0003

Your information will automatically be uploaded to your file at our office.  We also require a valid State issued ID and Insurance card(s) which we will get at your new patient appointment.

Contact Us

Send us an email today!

Our Locations

Find us on the map