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Download Our Patient Forms

Patient forms
Restoration Health Chiropractic

To save time during your first visit, you can download and complete the following forms to the best of your ability.  If you have any questions, our knowledgeable staff can assist you at your appointment.

Patient Intake Form

Pediatric Intake Form

Consent to Care Form

HIPAA Privacy Form

Payment Policy Form

Download All Forms

We are here to help...

For general questions or to speak to one of our experts, send us a message.

Our Hours
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We are here to help...

For general questions or to speak to one of our experts, send us a message.

Our Hours
Follow Us

Chiropractor serving Palm Bay, Melbourne,
West Melbourne, Suntree, Viera & the Beaches

Request an Appointment

To request an appointment, fill out the form below and a Restoration Health team member will reach out to schedule your appointment.