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Your Health. Our Passion.

2826 Old Lee Highway #350
Fairfax, Va 22031

Chiropractor Merrifield and Fairfax Va
Lower Back Pain Relief Merrifield and Fairfax Va
Specialized Chiropractic Treatment Plans
Neck Pain Relief Merrifield and Fairfax VA
Knee Pain Relief Merrifield and Fairfax Va
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New Patient Paperwork

Concept Chiropractic and Rehab offers our patient form(s) online so they can be completed in the convenience of your own home or office.

All forms are PDF files. You will need AdobeReader® to view them.

If you do not already have AdobeReader® installed on your computer,  CLICK HERE TO DOWNLOAD

Download the necessary form(s), print them out and fill in the required information. Fax us your printed and completed form(s) or bring them with you to your first appointment.

Your First Visit:

Please plan to arrive at our clinic 15 minutes prior to the start of your first appointment to complete your new patient paperwork, which includes information about your current chief complaint, past medical history, family medical history, current functional status and pain level.

 

On Your First Visit Please Bring:

  • Any Recent Imaging taken in the last 6 months (X-rays, CT Scans, MRIs) for your current Chief Complaint
  • Identification
  • Health Insurance Card
  • Completed Patient Registration Forms(if filled out from our website)
  • Wear Comfortable Clothes