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New Patient Information

Welcome to Life Chiropractic/Back in Action! We know your time is precious so we've made our patient forms available on this page.

To save yourself time, download and print these pages with Adobe Acrobat Reader which is free to download and use.

After filling out these pages, you can carry them into the office or fax them if convenient. We welcome you into our care!

Dr. Bruce Stevens 

 

Initial Office Visit Forms

Personal Health History        Pediatric  Form        Personal Injury

 

Get Adobe Acrobat Reader

Most Insurance Plans Accepted

Visa    MasterCard    Debit Cards 

Payment plans are available

 

 

 

Discover Chiropractic Today.... For A Healthier Tomorrow!

 

 

 

 

Life Chiropractic/Back In Action - 217-A West Central Ave, Lompoc CA
Phone: 805-737-5656

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