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Wendover Avenue in Greensboro NC Office Phone Lawndale, NC Office Phone Oak Ridge, NC Office Phone Winston-Salem NC Office Phone
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NEW PATIENT FORMS

New Patient Welcome Form
To be filled out by all new patients.
(PDF Format)

 New Patient History Intake-Form
To be filled out by all new patients.
(PDF Format)
If this injury is related to an auto injury, please use the form below.
 New Patient Auto Injury
Questionaire
(PDF Format)

 If this injury is related to an auto injury, please use the form below.
Informatcion de Accidente
de Coche
(PDF Format)

(Adobe Acrobat Reader is required.)

 


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© 2008 Salama Chiropractic
Greensboro, Oak Ridge & Winston-Salem, North Carolina (NC) Chiropractors
3410 W. Wendover Ave. Ste. A Greensboro, North Carolina 27407
 Phone: 336-274-3500 / Fax: 336-292-1928
2608-A Lawndale Dr. Greensboro, North Carolina 27407
Phone: 336-540-1040 / Fax: 336-540-1041
1692 NC Hwy. 68 Ste. E Oak Ridge, North Carolina 27310
Phone: 336-644-6446 / Fax: 336-644-6442
1515 Hanes Mall Blvd. Winston-Salem, North Carolina 27103
Phone: 336-773-7373 / Fax: 336-765-7006

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