Online Forms

Active Wellness Chiropractic Center offers our patient form(s) online so they can be completed it in the convenience of your own home or 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!

Download & Print Form



Download the Free AdobeReader®

 

Location

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Office Hours

Our Regular Schedule

Monday:

9:30 am-1:00 pm

3:00 pm-7:00 pm

Tuesday:

9:30 am-1:00 pm

3:00 pm-7:00 pm

Wednesday:

Closed

Thursday:

9:30 am-1:00 pm

3:00 pm-7:00 pm

Friday:

9:30 am-1:00 pm

3:00 pm-7:00 pm

Saturday:

1:00 pm-3:00 pm

Sunday:

Closed

Testimonial

  • "I am a strong believer in Dr. Burg and his Active Release Technique. By far this is the most effective method I have had in comparison to other methods of chiropractic, acupuncture, physical therapy, massage... let alone other doctors! Dr. Burg knows how to eliminate my pain very effectively!!"
    Alice C./Oakland, CA