New Patient Forms

Bridgewater 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 PC, Click Here to download. Download the necessary form(s), print it out and fill in the required information. You may fax us 724-888-2458 your printed and completed form(s) or bring it with you to your appointment.


New Patient Health History Form & Informed Consent - 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 Forms:  New Patient History Form & Consent Form (5 Pages Total)

*Download the Free AdobeReader®

Exclusive Offer

New Patients Receive a Free Consultation

Office Hours

Our Regular Schedule

Monday:

9:00 am-1:00 pm

3:00 pm-7:00 pm

Tuesday:

9:00 am-1:00 pm

3:00 pm-7:00 pm

Wednesday:

9:00 am-1:00 pm

3:00 pm-7:00 pm

Thursday:

9:00 am-1:00 pm

3:00 pm-7:00 pm

Friday:

Closed

Saturday:

10:00 am-1:00 pm

Closed

Sunday:

Closed

Location

Find us on the map

Testimonial

  • "I was in a motor vehicle collision last year which really scared me. After 40 stitches in the head, a hospital stay, some drugs and continuous neck pain, I finally decided to see a Chiropractor. I have NEVER looked back. Not only did Dr. Bello work with my lawyer to submit documentation of my injuries for compensation, I have never received the type of one-on-one care I have from another healthcare professional. I now continue to see Dr. Bello twice a month for maintenance and slowly but surely I am getting back on my feet."
    Bridgewater, PA

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