Patient Forms

Back to Health Chiropractic Office

Are you ready to become a patient at Back to Health Family Chiropractic in St. Albans? Ready to get your health and wellness on the right track without drugs, painkillers, or other harmful products? Great!

For your current, new, and prospective patients, we offer online, printable PDF versions of the paperwork you'll need to update before your appointment. The following links use Adobe Acrobat ReaderĀ® or similar PDF viewer installed on your device. Update your device with the latest version by click here to download it now.

Once you're done, you can either bring the forms with you to your appointment or send them to us by fax at (802) 527-2013.

Patient Intake Form

1 Required paperwork for all patients 13 years of age and older.
2 Required for all patients with Medicare as their primary insurance provider.
3 Required for all patients 12 years of age and under. Please note, youth patients' parental guardian must be present during initial visit. For more information, contact us by clicking here.

Please note...

Due to Covid Staff shortage, our office hours may vary. Please call to make sure we are open.


Office staff: 8am - 5pm

Doctors: 8:15 -10:15 (+Emergencies)


Office staff: 7:30am - 6pm

Doctors: 7:30am-12:00 4:00-6:00


Office staff: 8am - 6pm

Doctors: 2pm - 6pm


Office staff: 7:30am - 4pm

Doctors: 7:30am - 12pm


Office staff: 8am - 1pm

Doctors: 8:15-10 (+ Emergency calls)


Office staff: closed

Doctors: Emergency only


Office staff: closed

Doctors: Emergency only