Please download, print, and fill out all necessary new patient intake forms
This will ensure that you get the best treatment for your specific problem + determine proper insurance coverage and finding the best payment plan available to you
Application for care intake form
GENERAL APPLICATION FOR NEW PATIENT INTAKE FORM.
Auto injury intake form
FOR ALL NEW PATIENTS WITH AUTO RELATED INJURIES
Pediatric care Intake form
PEDIATRIC CARE INTAKE FORM IS FOR ALL PATIENTS BELOW 18-YEARS OLD
“Dr. Weeks performs an all encompassing life transforming treatment. With direct response feedback testing you can feel yourself getting stronger right there on his adjustment table.”
- Patient, David R.