Online Forms

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Online Forms

We offer our patient form(s) online so they can be completed it 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!

Click here for Newark Intake Form
Click here for Clifton Intake Form
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Visit our Office

If you are located in Newark, Elizabeth, East Orange, Irvington, North and South Ironbound and the surrounding areas, or Clifton and the surrounding areas, and are still uncertain about whether we are the right clinic for you, feel free to browse our website to learn more about what kinds of treatment and care we can offer you and your loved ones. If you are suffering from back pain, sciatica, an auto injury, or any other recurring pain, please call us to schedule an appointment
Newark : 973-344-0012
Clifton : 973-546-4200
Request An Appointment