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910-575-2225
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FREE REPORT - 5 Truths about Heavy Metals that are Poisoning you RIGHT NOW

At the Beach Chiropractic Health Center offers our functional medicine 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.

Functional Medicine 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

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Online Forms
Our patient forms are available online so they can be completed in the convenience of your own home or office.