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Patient Forms

Initial 1st visit
For your convenience you may print these forms out and fill them out and bring them with you to save nearly 20 minutes on your first visit.

Child (Newborn to 12 yrs old) 1st Visit
For your convenience you may print these forms out and fill them out and bring them with you to save nearly 20 minutes on your first visit.

Automobile Accident 1st visit
For your convenience you may print these forms out and fill them out and bring them with you to save time on your first visit.

Work Related Injury 1st visit
For your convenience you may print these forms out and fill them out and bring them with you to save time on your first visit.

Vaccine Exemption
In most states including Pennsylvania you are NOT required to vaccinate your child. However, if you wish to not vaccinate you must have a signed exemption. This exemption is found on the back of the "official" vaccination form. However, most schools copy only the front of the form and not the exemption.

Twitter Updates

DrRayW: Debunking myths about chiropractic care. Chiropractors are, in fact, real doctors: http://bit.ly/CyU1r
04 Sep 2009
DrRayW: Debunking myths about chiropractic care. Chiropractors are very well-educated: http://bit.ly/TZQfA
04 Sep 2009
DrRayW: Debunking myths about chiropractic care. Chiropractic care IS scientific: http://bit.ly/uZa4Q
04 Sep 2009
DrRayW: Subluxation: sub = less than | luxation = dislocation. Only chiropractors find and correct vertebral subluxations. http://bit.ly/dHY4z
04 Sep 2009
DrRayW: Please join us at our FREE Weight Loss Seminar at our chiropractic office Saturday, September 19th. Trigger your 6 fat burning hormones!
04 Sep 2009
DrRayW: Debunking the most common myths about chiropractic care. Learn the facts and take control of your health! http://bit.ly/3qzXis
04 Sep 2009

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