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Auckland City Chiropractic offers our patient form(s) online so that they can be completed in the convenience of your own home or 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.

Click Here for New Patient Form


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website.  You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office.  You can print it out and bring it in to our office or Click Here to register online!  The online newsletter sign-up is also on the right.  We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form



Download the Free AdobeReader®

Sign up using the form below or call 09-377-5377 to make an appointment.

THIS ---->https://aucklandcitychiropractic.chiromatrixbase.com/new-patient-center/online-forms.html

Office Hours

Day
Monday8am5pm
Tuesday8am5pm
Wednesday8am5pm
Thursday8am5pm
Friday8am2pm
SaturdayClosed
SundayClosed
Day
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8am 8am 8am 8am 8am Closed Closed
5pm 5pm 5pm 5pm 2pm

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