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Chiropractic Health Clinic 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 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


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form


Download the Free AdobeReader®

Call us at 321-459-9400 to make your appointment

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THIS ---->https://merrittislandchiropractor.com/new-patient-center/online-forms.html

Office Hours

Day
Monday8:00am - 12:00pm3:00pm - 6:00pm
TuesdayClosedClosed
Wednesday8:00am-12pm3:00pm - 6:00pm
Thursday8:00am-12pm3:00pm - 6:00pm
FridayClosedClosed
SaturdayBy AppointmentClosed
SundayClosedClosed
Day
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8:00am - 12:00pm Closed 8:00am-12pm 8:00am-12pm Closed By Appointment Closed
3:00pm - 6:00pm Closed 3:00pm - 6:00pm 3:00pm - 6:00pm Closed Closed Closed

Testimonial

Dr. Grimm runs a very professional office in Merritt Island Fl. He takes no shortcuts, he identifies what the problem is and whether he can help or not. After years of sciatic and lower back pain, I went in to see Dr. Grimm. Within one week I had significant relief from this chronic pain. I still go to the Chiropractic Clinic to maintain my spines alignment and I could not be happier with the service. I recommend Dr. Grimm to everyone I meet that is having back or neck problems.

David M.
Merritt Island, FL

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