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Online Forms

Rockenmacher Chiropractic and Sports Medicine 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

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!

Cash Patients (For patients who do have insurance or wish to not bill insurance):

Download & Print

Download & Print (minor)

Group Insurance Patients (PPO, EPO, POS etc...):

Download & Print

Download & Print (minor)

American Specialty Health (ASH/HMO) Patients:

Download & Print

Download & Print (minor)

Medicare Patients:

Download and Print

Personal Injury Patients:

Download & Print Motor Vehicle Accident

Download & Print Motor Vehicle Accident (minor)

Download & Print Motorcycle Accident

Download & Print Motorcycle Accident (minor)

Download & Print Bicycle Accident

Download & Print Bicycle Accident (minor)

Download & Print Pedestrian Accident

Download & Print Pedestrian (minor)

Download & Print Slip & Fall Accident

Download & Print Slip & Fall (minor)



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(No exam or treatment is done during this appointment. This appointment is only to discuss whether chiropractic treatment is an option for you)

Location

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Office Hours

Our Regular Schedule

Dr. Rockenmacher

Monday:

8:00 am-12:00 pm

3:00 pm-6:00 pm

Tuesday:

12:00 pm-1:00 pm

Wednesday:

8:00 am-12:00 pm

3:00 pm-6:00 pm

Thursday:

7:00 am-10:00 am

Friday:

8:00 am-12:00 pm

3:00 pm-6:00 pm

Saturday:

Closed

Sunday:

Closed

Dr. Abella-Desuyo

Monday:

8:00 am-12:00 pm

3:00 Pm-6:00 pm

Tuesday:

10:00 am-2:00 pm

3:00 pm-6:00 pm

Wednesday:

8:00 am-12:00 pm

3:00 pm-6:00 pm

Thursday:

10:00 am-12:00 pm

1:00 pm-3:00 pm

Friday:

8:00 am-12:00 pm

3:00 pm-6:00 pm

Saturday:

Closed

Sunday:

Closed

Massage Hours

Monday:

1:00 pm-6:00 pm

Tuesday:

Closed

Wednesday:

2:00 pm-7:00 pm

Thursday:

11:00 am-3:00 pm

Friday:

2:00 pm-7:00 pm

Saturday:

Closed

Sunday:

Closed