Online Forms

Tompkins Chiropractic Center 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!

Patient Intake Form: Download & Print Form

Informed Consent and Verbal Communication Release Form

Download & Print Form

Method of Payment

Download & Print Form

HIPPA Notice of Privacy Practices 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

Location

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Office Hours

Our Regular Schedule

Monday

9:00 am - 12:00 pm

1:00 pm - 5:00 pm

Tuesday

9:00 am - 12:00 pm

1:00 pm - 5:00 pm

Wednesday

9:00 am - 12:00 pm

1:00 pm - 5:00 pm

Thursday

9:00 am - 12:00 pm

1:00 pm - 5:30 pm

Friday

Closed

Saturday

Closed

Sunday

Closed

Monday
9:00 am - 12:00 pm 1:00 pm - 5:00 pm
Tuesday
9:00 am - 12:00 pm 1:00 pm - 5:00 pm
Wednesday
9:00 am - 12:00 pm 1:00 pm - 5:00 pm
Thursday
9:00 am - 12:00 pm 1:00 pm - 5:30 pm
Friday
Closed
Saturday
Closed
Sunday
Closed