New Patient Forms

Thank you for becoming a patient with us! We are excited to meet you. Please take a moment to fill out the following new patient forms to allow us to give you the best possible experience at the office.  First and second forms are electronic submissions while the last 2 forms are PDF files for you to read. Any signatures will be done in office. A Systems Survey will be mailed to you to fill out and bring with you to your first appointment.

By filling out these form you are consenting to receive SMS from Smith Chiropractic & Nutrition. Frequency may vary. Message & data rates may apply. Reply STOP to opt-out or HELP for more information. View our terms and privacy policy below.

Privacy Policy

Smith Chiropractic & Nutrition is committed to safeguarding the privacy of our users. We want to assure you that we do not share your personal information with third parties. This privacy policy outlines how we collect, use, and protect the information you provide to us. Information Collection: We collect only the information necessary to provide and improve our services. This may include name, phone number, email address, etc. We do not sell, rent, or share this information with any third parties. How We Use Your Information: The information collected is used solely for communicating with the intended party. We do not share your information with external parties for marketing or any other purposes. Your Choices: You have the right to access, correct, or delete your information. If you have any concerns or questions about your data, please contact us at 704-817-4745. Policy Changes: We may update our privacy policy from time to time. Any changes will be communicated to you, and your continued use of our services implies your acceptance of the updated policy. By using our services, you agree to the terms outlined in this privacy policy. Last updated: December 9, 2024