Online Forms

Health Loft ChiropracticNew Patient CenterOnline Forms

New Patient Forms

Please download the necessary forms below and have them filled out for your first visit.

Terms of Acceptance

Download Form (.pdf)

Pediatric Intake

Download Form (.pdf)

Adult Intake

Download Form (.pdf)

Quadruple Visual Analogue Scale

Download Form (.pdf)

Contact Info

Address	6850 North Rochester Rd Rochester, MI 48306 Get Directions →
Phone	(248) 963-1118
Email	admin@healthloftchiro.com

Social Media

Monday	9:00 am – 1:00 pm3:00 pm – 5:00 pm
Tuesday	2:00 pm – 6:00 pm
Wednesday	9:00 am – 1:00 pm3:00 pm – 7:00 pm
Thursday	Closed
Friday	9:00 am – 2:00 pm
Saturday	8:00 am – 12:00 pm
Sunday	Closed