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716-635-9742 H
H

716-635-9742

Online Forms

Chiropractic Lifestyle Family Practice offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic 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!

Download & Print Form


Download the Free AdobeReader®

Exclusive Offer

New patients only! $37 Includes initial consultation and exam!

Sign-up using the form or call us at 716-635-9742 to take advantage of this exclusive offer.

Office Hours

DayMorningAfternoon
Monday7:00 - 12:003:00 - 6:00
TuesdayClosedClosed
Wednesday7:00 - 12:003:00 - 6:00
ThursdayClosedClosed
Friday7:00 - 12:003:00 - 6:00
SaturdayClosedClosed
SundayClosedClosed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
7:00 - 12:00 Closed 7:00 - 12:00 Closed 7:00 - 12:00 Closed Closed
3:00 - 6:00 Closed 3:00 - 6:00 Closed 3:00 - 6:00 Closed Closed