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Online Forms

Urban Family 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!

Adult Member Health Record Form

Accident Incident History Form

Motor Vehicle Accident History Form

Workers Compensation Record Form


New Patient Child History Form (For Patients 13 and Under) - Required

Pediatric Health Record Form – Ages 0-3

Pediatric Health Record Form – Ages 4-8

Pediatric Health Record Form – Ages 9-13



Download the Free AdobeReader®

Location

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Office Hours

Our Regular Schedule

Garden City

Monday:

9:00 am-1:00 pm

3:00 pm-6:00 pm

Tuesday:

3:00 pm-6:00 pm

Wednesday:

9:00 am-1:00 pm

3:00 pm-6:00 pm

Thursday:

3:00 pm-6:00 pm

Friday:

9:00 am-1:00 pm

Saturday:

Closed

Sunday:

Closed

Testimonials

Reviews By Our Satisfied Patients

  • "Urban Family is our primary care physician because they work at curing a person. Excellent service and we get results. Try it and you will see!"
    Tanya S.
  • "Great service ! UFC staff is personable and caring. I have had multiple treatments over the years with great results!
    Thanks to the UFC team for excellent customer care!"
    KarTay C.