Online Forms

Poirier Chiropractic 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 AdobeReaderĀ® 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

Pediatric Form 0-4 Months
Pediatric Form 5-12 Months
Pediatric Form 13-36 Months
Pediatric Form 4-12 Years



Hours of Operation

Monday

9:30 am - 12:30 pm

3:00 pm - 7:00 pm

Tuesday

2:30 pm - 5:30 pm

Wednesday

9:30 am - 12:30 pm

3:00 pm - 6:30 pm

Thursday

Closed

Friday

9:30 am - 12:30 pm

3:00 pm - 6:00 pm

Saturday

9:00 am - 12:00 pm

Sunday

Closed

Monday
9:30 am - 12:30 pm 3:00 pm - 7:00 pm
Tuesday
2:30 pm - 5:30 pm
Wednesday
9:30 am - 12:30 pm 3:00 pm - 6:30 pm
Thursday
Closed
Friday
9:30 am - 12:30 pm 3:00 pm - 6:00 pm
Saturday
9:00 am - 12:00 pm
Sunday
Closed

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