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Online Paperwork For Precision Spinal Care

We offer our paperwork on line so you can complete it in the convenience of your own home. Please fill out this form and bring it with you on your first visit with your Chiropractors in Chesapeake.

New Patient Chiropractic Intake Forms

This lets us know what’s happened with your health, and where you want it to go in the future!
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Additional Forms for Personal Injury Patients Only (Auto Accident)

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pdf iconMechanisms of Injury, Download & Print Form

Find Your Symptom Vertebral Subluxation and Nerve Chart

Misalignment of spinal vertebrae and discs may cause irritation to the nervous system which could affect the structures, organs, and functions listed under “areas” and the “possible symptoms” that are associated with malfunctions of the areas noted.
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Free AdobeReader®

Each form is a PDF document file. If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.

Call your Chesapeake Chiropractor now to schedule an appointment and learn more about chiropractic care!

Precision Spinal Care | (757) 382-5555