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Online Forms

Please print and fill out the forms for your specific visit and bring them with you. 

For New Chiropractic Patients

New Patient Intake Form - Chiropractic

New Patient Pain Diagram

Medical Release Form

For Medicare patients

Medicare Patient Form

For Patients with United Healthcare Insurance
Chiropractic
       Consent to Treat Minors

Consent to Treat Minor Form

Massage
For Massage Visits

New Patient Intake Form - Massage

For Automobile Accident Patients

Legacy Chiropractic and Wellness

2100 Data Park Circle, Suite 100

Hoover, AL 35244

Tel. 205-985-9888

Fax. 205-985-9895

Monday 8:00-1:00 / 3:00-6:00

Tuesday 8:00-1:00 / 3:00-6:00

Wednesday 8:00-1:00

Thursday 8:00-1:00 / 3:00-6:00

Friday 9:00-1:00

Saturday Massage only (by appointment)

Sunday  Massage only (by appointment)

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For Life-Threatening Emergencies

Call 911

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Proudly made by Ali Muhammad

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