New Patient Paperwork

Peak Family Chiropractic offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • All forms are PDF files. You will need AdobeReader® to view them.
  • If you do not already have AdobeReader® installed on your computer,
    Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Bring the necessary form(s) to your appointment.

Adult (18 and over)

Pediatric (Age 5-17)

Pediatric (Infant - age 4)

Clinical Nutrition

OFFICE HOURS


Monday
8:00am - 12:00pm
3:00pm - 6:00pm


Tuesday
3:00pm - 6:00pm


Wednesday
8:00am - 12:00pm
3:00pm - 6:00pm


Thursday
3:00pm - 6:00pm


Friday
8:00am - 12:00pm


Saturday
Closed

Peak Family Chiropractic
132 Merz Boulevard
Fairlawn, OH 44333
(330) 670-9400