3961 Ridge Pike  Collegeville, PA 19426 • 610-489-3600 • Mon, Wed & Fri 7:00-12:00pm & 2:00-7:00pm  Sat 7:30-11:00am

New Patient Info

To better accomodate our patients, Collegeville Chiropractic Center has provided online access to our patient form(s) so that they can be reviewed in advance and filled out in the convenience of your own home or office space.

If you do not already have AdobeReader® installed on your computer, Click Here to download.

Click on the following links to save or download the necessary form(s) that applies to your situation. Once downloaded to your computer you can print the form(s) out and then fill in the required information.

Fax your printed and completed form(s) to (610) 489-3600 – OR – scan and EMAIL the form(s) OR simply fill the form(s) out and bring with you to your appointment.

LIST OF PRINTABLE FORMS:

Adult Health History Intake Form

HIPPA Privacy Notice

Workers Comp Intake Form

Auto Accident Questionnaire




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I have spent my entire career in the healing arts. First, armed with a Bachelor of Arts degree in psychology, I spent several years working in various positions in a locked, acute emergency care, psychiatric facility. After becoming disillusioned by the society’s ability to come to grips with mental illness and the reliance on pharmacology […]

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