Online Forms

Summers Wellness Center offers our patient form(s) online so they can be completed in the convenience of your own home or 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.

Chiropractic New Patient Forms

New Patient Intake Form

Symptom Survey Form

Terms of Acceptance

Privacy Notice

Cancellation Policy


Other Forms

Symptom Survey Form

Toxicity Questionnaire

New Patient Information Form

Nutrition Response Testing New Patient Orientation

Nutrition Response Testing Permission & Authorization Form


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Locations

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Office Hours

Our Regular Schedule

Summers Integrative Wellness

Monday:

12:00 pm-3:00 pm

Tuesday:

11:00 pm-6:00 pm

Wednesday:

2:00 pm-6:00 pm

Thursday:

11:00 pm-6:00 pm

Friday:

12:00 pm-3:00 pm

Saturday:

Closed

Sunday:

Closed