Intake Forms

We are pleased to introduce ONLINE patient registration for chiropractic patients.  Please allow one business day for processing.  We will do our best to find an appointment at or near your requested appointment time however, making a request is NOT a guarantee  Please complete the applicable fields in addition to the specific intake form for your service.  

A Therapeutic Effect

313 D Primrose Ln

Mountville, PA 17554

717.285.9955

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