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Online Forms

Cosh Chiropractic Care & Wellness Center offers our patient form(s) online so you can complete it in the convenience of your own home or office.  There are two options for New Patient paperwork submission.


 *** The quickest method of Intake Form submission is to select the following link and complete all pertinent and appropriate boxes. Your information will be immediately and securely sent to our office. Please be advised that some information may be requested from you upon arrival. 

**** ONLINE INTAKE FORM SUBMISSION (please click the following link to be directed to the online version of the Patient Intake Form)

https://www.mychirotouch.com//patientintake/?clientid=CCCA0003

OR

Arrive 30 minutes prior to your scheduled New Patient appointment to complete the Patient Intake Form in our office using the iPad.  

***Additional Forms Required. Utilize the 'Print & Complete' option OR complete the additional forms in the office prior to your appointment.

Print & Complete Required Office Forms (LEGAL FORMS):

/storage/app/media/REQUIRED_FORMS_COSHCHIRO.pdf

***PERSONAL INJURY ONLY:

Supplemental Intake Form (Personal Injury) 



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Location

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Office Hours

Our Regular Schedule

Monday:

9:00 am-12:00 pm

2:30 pm-5:00 pm

Tuesday:

9:00 am-12:00 pm

2:30 pm-5:00 pm

Wednesday:

9:00 am-12:00 pm

2:30 pm-5:00 pm

Thursday:

9:00 am-12:00 pm

2:30 pm-5:00 pm

Friday:

9:00 am-12:00 pm

2:30 pm-5:00 pm

Saturday:

Closed

Sunday:

Closed