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Online Forms

Online Forms for New Patients

Straight-Up Chiropractic offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Click the link below to download the necessary form(s), print, and fill in the required information.
  • Fax us your printed and completed form(s) to 330-725-5656 OR bring it with you to your appointment.

New Patient & Health History Forms - Download & Print



Download the Free AdobeReader®

Location

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Office Hours

Our Regular Schedule

Monday:

9:00 am-1:00 pm

3:00 pm-6:00 pm

Tuesday:

9:00 am-1:00 pm

3:00 pm-6:00 pm

Wednesday:

9:00 am-1:00 pm

3:00 pm-6:00 pm

Thursday:

9:00 am-1:00 pm

3:00 pm-6:00 pm

Friday:

Closed

Saturday:

By Appointment

Closed

Sunday:

Closed

Testimonials

Reviews By Our Satisfied Patients

  • "Dr Merrick has helped me and I am able to get up and go. I highly recommend him to any who tells me they are in pain."
    Carolyn