New Patient Form
Welcome to Bergen Chiropractic & Sports Rehabilitation Center
Thank you for choosing us to be part of your health and wellness journey.
Before your first visit, please take a few minutes to complete our Patient Form. This form helps us:
Learn about your health history and current concerns
Understand your personal goals and activity level
Create a customized treatment plan tailored to your needs
Your information will remain strictly confidential and will only be used to provide you with the best possible care.
You have two options to complete the form:
- Fill it out online using the secure form below
- Download the PDF, fill it out at your convenience, and bring it with you to your first appointment
Whichever you prefer, completing the form in advance helps us make your first visit smooth and efficient.
If you have any questions, don’t hesitate to contact our office — we’re here to help.