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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 completing  the required Intake form(s):


The quickest method to submit the Patient Intake Form is to select the following link and complete all pertinent and appropriate boxes. Complete the questionnaire as thoroughly as possible to ensure the proper form(s) populate to your chart. Your information will be immediately and securely sent to our office. Please be advised that some information may be requested from you upon arrival. 

(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 15 minutes prior to your scheduled appointment to complete the Patient Intake Form in our office using the iPad.  

Note: If patient is requesting treatment for a Personal Injury or a Work Related Injury the claim number and date of injury is required. 


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Office Hours

Our Regular Schedule

Office Hours

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