Here at ACT Chiropractic, we value our patients and want to do everything we can to eliminate any unnecessary stressors. This is why we include the option of printing and completing your forms at home. Fax us your printed and completed forms or bring them with you to your first visit. If you have any questions, please don’t hesitate to call us at 575-887-3263.
We think of our patients as part of our extended family, and we are excited to meet you!
Click the images below to download and print.
New Patient Form
Accidental Injury Form
Request an Appointment
Please complete the following form to request an appointment. Availability will vary depending on your request. Your appointment will be confirmed by phone by a member of our staff. Please DO NOT send personal health information through this form. Specific patient care must be addressed during your appointment.
Thank you!
