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Practice Name

Back in Motion Chiropractic

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Primary Location
10515 Bells Ferry Rd Ste 100
Canton, GA 30114
Phone: 770-704-0114
Fax: 770-704-0115

Office Hours

DayMorningAfternoon
Monday8:00 am6:00 pm
Tuesday9:00 am7:00 pm
Wednesday8:00 am6:00 pm
Thursday9:00 am7:00 pm
Friday8:00 am5:00 pm
Saturday8:00 am12:00 pm
SundayClosedClosed
Main Content

Back in Motion Chiropractic 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

Pediatric Patient Health History Form - Required

This is specific for pediatric patients.

Download & Print Form

Massage Client Health History Form - Required

This is specific for massage clients.

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 chiropractic office. You can print the form out and bring it in to our office during your next visit with our chiropractor, 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



Download the Free AdobeReader®

Exclusive Offer

New patients receive 15% OFF first Chiropractic visit.

Sign-up using the form or call us at 770-704-0114 to take advantage of this exclusive offer.

**May not be combined with insurance benfits

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Client Testimonials

From one chiropractor to another, Thank you for taking the time to examine my son Justin and his broken collar bone! Your expertise and time are appreciated!

- Dr. Peri

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Request Appointment

We will do our best to accommodate your busy schedule. Schedule an appointment today! Call us at 770-704-0114

Services

We strive to provide complete care for our patients. Learn more about all the services we provide.

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Contact

Back in Motion Chiropractic
10515 Bells Ferry Rd Ste 100
Canton, GA 30114
Get Directions
 
  • Phone: 770-704-0114
  • Fax: 770-704-0115
  • Email Us

Office Hours

DayMorningAfternoon
Monday8:00 am6:00 pm
Tuesday9:00 am7:00 pm
Wednesday8:00 am6:00 pm
Thursday9:00 am7:00 pm
Friday8:00 am5:00 pm
Saturday8:00 am12:00 pm
SundayClosedClosed
Newsletter

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