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Practice Name

Hands On Healing Chiropractic

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Primary Location
1925 Winchester Blvd, # 101
Campbell, CA 95008
Phone: 408-371-0068
Fax: 408-871-0733

Office Hours

DayMorningAfternoon
Monday9 am - 1 pm3 pm - 6:30 pm
Tuesday9 am - 1 pm3 pm - 6:30 pm
Wednesday9 am - 1 pm3 pm - 6:30 pm
ThursdayClosed3 pm - 6:30 pm
Friday9 am - 1 pmClosed
Saturday9 am - 1 pm1st & 3rd Saturday Each Month
SundayClosedClosed
Main Content

In order to provide you the best possible wellness care, please complete this form

Patient Data

Mailing Address

Current Complaints

Nature of Injury

Insurance Information

*If an auto accident, please provide:

Signatures

Name of the Insured _____________________________________________

I understand and agree that health/accident insurance policies are an arrangement between an insurance carrier and myself. I understand and agree that all services rendered to me and charged are my personal responsibility for timely payment. I understand that if I suspend or terminate my care/treatment, any fees for professional services rendered to me will be immediately due and payable.

Patient's signature _______________________________________________

Date ____________________

Spouse's or guardian's signature __________________________________

Date ____________________

Medical History

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Family History

Habits

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Featured Services

Services We strive to provide complete care for our patients. Learn more about all the services we provide. Make An Appointment We will do our best to accommodate your busy schedule. Schedule an appointment today! Online Forms Our patient forms are available online so they can be completed in the convenience of your own home or office.

Office Hours

DayMorningAfternoon
Monday9 am - 1 pm3 pm - 6:30 pm
Tuesday9 am - 1 pm3 pm - 6:30 pm
Wednesday9 am - 1 pm3 pm - 6:30 pm
ThursdayClosed3 pm - 6:30 pm
Friday9 am - 1 pmClosed
Saturday9 am - 1 pm1st & 3rd Saturday Each Month
SundayClosedClosed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
9 am - 1 pm 9 am - 1 pm 9 am - 1 pm Closed 9 am - 1 pm 9 am - 1 pm Closed
3 pm - 6:30 pm 3 pm - 6:30 pm 3 pm - 6:30 pm 3 pm - 6:30 pm Closed 1st & 3rd Saturday Each Month Closed

Contact

  • 1925 Winchester Blvd, # 101 Campbell, CA 95008
  • 408-371-0068
  • Get Directions
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