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Online Forms

Family Chiropractic of Lederach, LLC offers these forms online to be completed at your convenience. Complete ONLINE or print and bring to the office with you for your first visit, along with your insurance card and photo ID.

  • 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

Options:

1) ONLINE for CHIROPRACTIC

Click here to fill out digital form.

Download the Free AdobeReader®

2) PRINT for CHIROPRACTIC

Download, print, complete and bring to the office.

3) PRINT for MASSAGE

24 hour cancellation notice requested for massage (charge may apply)

Download, print, complete and bring to the office.

4) PRINT for REFLEXOLOGY

24 hour cancellation notice requested for reflexology. (charge may apply)

Download, print, complete and bring to the office.

4) PRINT for ACUPUNCTURE

24 hour cancellation notice requested for acupuncture. (charge may apply)

Download 1 and Download 2, print, complete and bring to the office.

5) PRINT for PATIENT PACKET

Updated policies for Family Chiropractic

Download Patient Policies

Download Maintenance Policy

Download Consent

Download Assignment

Download HIPAA

Need to contact us? Enter the information below or call 215-256-8006

Location

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Office Hours

Our Regular Schedule

Monday:

9:00 am-7:00 pm

Tuesday:

3:00 pm-7:00 pm

Wednesday:

9:00 am-7:00 pm

Thursday:

10:00 am-7:00 pm

Friday:

9:00 am-6:00 pm

Saturday:

9:00 am-11:00 am

Sunday:

Closed