Online Forms

Foley Wellness Center offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic 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

Your First Visit Includes:

  • A patient history to determine how your activities and lifestyle affect your condition.
  • A thorough 3-part exam to help determine the physical problems you have and the causes of your condition.
  • Diagnostic testing, therapies and chiropractic treatment as indicated by the results of your history and examination.
  • A referral to another health care provider, or for x-rays, if needed.

If possible, please fill out the appropriate intake form before you arrive.

Patient Intake Forms

Download & Print Age 13 to Adult Form
Download & Print Age 1 to Age 12 Form
Download & Print Birth to Age 1 Form

Patient Update Form

Download & Print Update Form

Massage Intake

Download & Print Massage Form

Download the Free AdobeReader®


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Office Hours

Our Regular Schedule


9:00 am-6:00 pm




9:00 am-6:00 pm


7:30 am-12:00 pm


9:00 am-6:00 pm


7:30 am-12:00 pm




Reviews By Our Satisfied Patients

  • "I initially came in for my low back pain. The doctor did adjustments on my low back, recommended Acute Phase and Myocalm as herbal muscle relaxers and in 4-5 treatments I had absolutely no back pain. I would like to thank everyone at the Foley Wellness Center for treating my lower back problem and getting me back on my feet and feeling 100%. Thanks!"
    Brian P.
  • "I had been to other chiropractors and had very little if any results with my neck and low back pain. Now I have much more range of motion in my neck and much less pain in my neck and low back. I am able to do a lot more things without being in pain. I also think that the omega-3 oils that they recommended I start taking helped not only my neck and back, but my whole body feel better. Thank you for making me feel better."
    Gerald J.