Online Forms

Harrisburg Area Chiropractic offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

Patient Information

Download & Print Form

Fill Out Online


Medical History Form

Download & Print Form

Fill Out Online


Patient Policies and Consent Form

Download & Print Form

Fill Out Online


X-Ray Consent for Women

Download & Print Form

Fill Out Online


Download the Free AdobeReader®

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Location

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Office Hours

Our Regular Schedule

Monday:

8:00 am-11:15 am

3:00 pm-6:30 pm

Tuesday:

Closed

3:00 pm-6:30 pm

Wednesday:

8:00 am-11:15 am

3:00 pm-6:30 pm

Thursday:

Closed

3:00 pm-6:30 pm

Friday:

8:00 am-11:15 am

Closed

Saturday:

9:00 am-10:00 am By Appointment Only

Closed

Sunday:

Closed

Closed