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Online Forms

Sargent Chiropractic Clinic offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • 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.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form

Assignment of Benefits Form

Download & Print Form

Child Informed Consent Update

Download & Print Form

HIPAA Privacy Practice Statement Update

Download & Print Form

Informed Consent Adult

Download & Print Form

Patient Financially Responsible Form Update

Download & Print Form


Download the Free Adobe Reader®

Location

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Office Hours

Our Regular Schedule

Office Hours

Monday:

8:00 am-12:00 pm

2:00 pm-6:00 pm

From 5pm-6pm is by appointment (in advance only)

Tuesday:

2:00 pm-6:00 pm

From 5pm-6pm is by appointment (in advance only)

Wednesday:

8:00 am-12:00 pm

2:00 pm-6:00 pm

From 5pm-6pm is by appointment (in advance only)

Thursday:

8:00 am-12:00 pm

2:00 pm-6:00 pm

From 5pm-6pm is by appointment (in advance only)

Friday:

8:00 am-12:00 pm

Saturday:

Closed

Sunday:

Closed