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Pleasant Valley Location

1395 Route 44

Pleasant Valley, New York 12569 United States

845.635.5002

Mount Kisco Location

103 South Bedford Road, Suite 109

Mount Kisco, NY 10549 US

914.241.8000

Online Forms

Atlantic Chiropractic & Injury Care 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



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Location

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Office Hours

Our Regular Schedule

Monday:

9:00 am - 6:00 pm

Tuesday:

8:00 am - 6:00 pm

Wednesday:

9:00 am - 6:00 pm

Thursday:

8:00 am - 6:00 pm

Friday:

9:00 am - 6:00 pm

Saturday:

By Appt.

Sunday:

Closed