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In order to make your visit as simple and enjoyable as possible, please fill out the proper paperwork & information PRIOR to your visit. 

If you have questions, don't hesitate to call and ask one of our staff...


NEW PATIENTS

New Patient Information & Health History - Required

Click the link below to fill out & submit your information online over our secure server.

New Patient Information

*Please be sure to "complete" the personal & contact information sections.

**If you are a Personal Injury (PI) patient in addition to the "New Patient Information" above you must also fill out the paperwork from link below & bring it in with you during your visit.

***In additon if you have ASH, CVT or SISC insurance you must also click the link below to print out the ASH Authorization packet.

ASH/CVT/SISC 1st Visit Authorization Packet



Current ASH/CVT/SISC Patients

Complete & bring in the following packet for your "Paperwork" visit.


Personal Injury / Car Accident Forms




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Contact

Dewald Chiropractic
1037 West Avenue "N", Suite 101
Palmdale, CA 93551
Get Directions
  • Phone: 661-266-3500
  • Fax: 661-266-3591
  • Email Us

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