Online Forms

Back to Wellness Clinic 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 for all chiropractic and massage therapy patients

This lets us know the history and current state of your health.

New Patient Paperwork (Revised 8/30/18)


Acupuncture and Nutrition Intake form - Required for acupuncture and nutrition patients only

These forms allows our acupuncturist, Dr. Sung W. Han and nutritionist, Dr. Jean K. Lawrence to know the history and current state of your health, along with any questions, concerns and goals regarding your acupuncture visit.

Download & Print Form

Nutrition Form




Download the Free AdobeReader®

Office Hours

Our Regular Schedule

Monday:

8:30 am-5:00 pm

Tuesday:

8:00 am-5:00 pm

Wednesday:

8:30 am-5:00 pm

Thursday:

8:00 am-5:00 pm

Friday:

8:30 am-5:00 pm

Saturday:

Closed

Sunday:

Closed

Location

Find us on the map

Testimonial

Review By Our Satisfied Patient

  • "I have benefited tremendously from the chiropractic care I received from Dr. Hughes."
    George W./Rutledge, GA

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