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Online Forms

Florida Chiropractic Health Center offers our patient form(s) online so you can complete 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 let’s 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


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form


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East Orlando Office

7806 Lake Underhill Rd.

Suite 104

Orlando, FL 32822

407-730-9311

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Contact

Florida Chiropractic Health Center
1900 Boothe Circle Suite 100
Longwood, FL 32750
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  • Phone: 407.774.6800
  • Fax: 407.774.6806
  • Email Us

Longwood Office

1900 Boothe Circle

Suite 100

Longwood, FL 32750

407-774-6800

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407-772-CRASH