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Upchurch 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.

Health Questionnaire

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form




Download the Free AdobeReader®

Exclusive Offer

Initial Office Visit for only $59!
Includes Personal Consultation, Initial Examination & Two X-Rays

Click Here to view this special

THIS ---->https://upchurchchiropracticcom.chiromatrixbase.com/online-forms.html

Office Hours

DayMorningAfternoon
Monday10:00 - 11:302:30 - 6:30
TuesdayClosed2:30 - 6:30
Wednesday9:00 - 11:302:30 - 6:30
ThursdayClosed2:30 - 6:30
Friday10:00 - 11:302:30 - 6:30
SaturdayClosedClosed
SundayClosedClosed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
10:00 - 11:30 Closed 9:00 - 11:30 Closed 10:00 - 11:30 Closed Closed
2:30 - 6:30 2:30 - 6:30 2:30 - 6:30 2:30 - 6:30 2:30 - 6:30 Closed Closed

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My neck/shoulder pain is basically gone! I had a difficult time working, sleeping and driving because the pain was so bad. My arms and hands were getting numb and weak. Since I had gotten results with Dr. Upchurch before, I returned and again, I feel so much better!! I highly recommend Dr. Upchurch for neck and low back pain!

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