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Vitality 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.

Adult Intake Form

Download & Print Form

Child Intake Form

Download & Print Form

Pregnancy Intake Form

Download & Print Form



Download the Free AdobeReader®

Exclusive Offer

New Patients receive a Free Consultation.

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

Office Hours

DayMorningAfternoon
Monday8:00am6:00pm
TuesdayBy ApptBy Appt
Wednesday9:00am6:00pm
Thursday9:00am6:00pm
Friday6:30am1:00 pm
SaturdayClosedClosed
SundayClosedClosed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8:00am By Appt 9:00am 9:00am 6:30am Closed Closed
6:00pm By Appt 6:00pm 6:00pm 1:00 pm Closed Closed

Testimonials

I've never had chiropractic work until recently. Dr Ed gave me my first adjustment and he makes you feel like part of the family! I felt so welcome and respected, he has my trust and I will go no where else! Great facility full of fantastic people!

Kimberly K.

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