Online Forms

Gutierrez Family Chiropractic offers our patient form(s) online so 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!

Download & Print Form

Download Our Forms Today

At Gutierrez Family Chiropractic, a local, family owned and operated chiropractic clinic, we're committed to making your visit as pleasant as possible. We have been providing effective chiropractic treatment since 1964, and use the latest technology and known practices to adjust your spine and promote proper nerve function.

Download our patient forms today and have them ready when you come in for your appointment. Call us today at 360-658-3818 to schedule an appointment.


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Appointment Request

Fill out the fields below and one of our staff members will contact you as soon as possible.

Maps & Directions

Our main location

Business Hours

Call to check availability.

Monday:

8:00 am-12:00 pm

2:00 pm-6:00 pm

Tuesday:

8:00 am-12:00 pm

Wednesday:

8:00 am-12:00 pm

2:00 pm-6:00 pm

Thursday:

Closed

Friday:

8:00 am-12:00 pm

2:00 pm-6:00 pm

Saturday:

By Appointment Only

Sunday:

Closed