Online Patient Intake Form

The information you submit will be sent securely directly to our office, speeding up your office visit and allowing us to better serve your healthcare needs.

Printable Patient Intake Forms

Basic Patient Intake Form

(Standard Form)

Simply print out the form, complete the information requested, and bring the completed form with you to your appointment.

Supplemental Intake Form

(for Personal Injury)

Simply print out the form, complete the information requested, and bring the completed form with you to your appointment.

Ringgold Location

5721 Battlefield Pkwy
Ringgold, GA 30736

Phone: 706-935-7729
Fax: 855-847-7647

Dalton Location

715 S Thornton Ave
Dalton, GA 30720

Phone: 706-609-0023
Fax: 706-609-0039

Best Chiropractor

Pray Chiropractic

FREE PAIN EVALUATION. CONTACT TODAY!

Call: 706-935-7729

Contact Us:

Most Insurance Accepted




Pray Chiropractic

FREE PAIN EVALUATION. CONTACT TODAY!

Call: 706-935-7729

Contact Us:

Most Insurance Accepted