Intake Forms

blk-phone724-940-3900

141 Wexford Bayne Road Wexford,PA 15090 PA, 15090

Patient Intake Forms

Click icon below to download our newpatient form as a PDF Document.

Once downloaded, print, fillout ,and bring with you to your next officevisit.


pdfAuto_Accident_Patient_Information.pdf

pdfNew_Patient_Intake_Form.pdf

 

OR

 

Simply click here and fill out the intake form online and submit it to us directly (this is new!!)

 

 

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If you do not have Adode Reader click the Icon below to download a free copy.


forms

Intake Forms

Save time by downloading our intake forms.
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Payment Options

Our payment options are flexible and convenient.
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firstvisit

My First Visit

Find out what to expect at your first visit.
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Photo Gallery

Photo gallery of  Live Well Chiropractic.
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We accept UPMC, HIGHMARK, MEDICARE, AETNA, CIGNA, HEALTH
AMERICA, WORKER'S COMP, AUTO,
most insurances accepted!

Office Hours

Mon 8 am -  6:00 pm
Tue
2:00 - 6:00 pm
Wed 8 am -  6:00 pm
Thur
closed
Fri
8 am -  6:00 pm
Sat 8:30 - 10:00 am
Sun Closed

Special Offer

Register to get your special offer!
Offer available for the first 20 patients.


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3D Patient Education

Interactive 3D Education. Subluxation, Degeneration and Nervous System Interference.

Launch

Get Directions

Need help finding us? We make it easy for you to find us with google maps.

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Contact Us

724-940-3900

 

marker141 Wexford Bayne Road
  Wexford, PA 15090