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New patients receive complete consultation, spinal examination and x-rays for just $150 (normally up to $315).*

*Cash Patients only please. We accept most insurance plans as well as medicare, medicaid, workers comp and PIP (Auto Injury) claims.

Online Forms

Brevard Chiropractic & Injury Center offers our patient form(s) online so they can be completed it 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 Forms - Auto Injury

Download & Print Form

New Patient Forms - General

Download & Print Form

New Patient Forms - Injury (Non-Auto Related)

Download & Print Form

New Patient Forms - Massage Only

Download & Print Form