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Online Forms

Bolt Chiropractic Family Wellness 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.

General Intake Form

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


Patient Health Information Consent Form - Required

Download & Print Form


Informed Consent to Chiropractic Treatment

Download & Print Form


Personal Injury Questionnaire

Download & Print Form



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Location

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Office Hours

Our Regular Schedule

Monday:

9:00 am - 12:00 pm

3:00 pm - 6:00 pm

Tuesday:

9:00 am - 12:00 pm

3:00 pm - 6:00 pm

Wednesday:

9:00 am - 12:00 pm

3:00 pm - 6:00 pm

Thursday:

9:00 am - 12:00 pm

3:00 pm - 6:00 pm

Friday:

Closed

Closed

Saturday:

Closed

Closed

Sunday:

Closed

Closed

Testimonial

Reviews By Our Satisfied Patients

  • "Dr. Bolt helped me not only by adjusting my spine, but by educating me about holistic approach and overall health and wellness for life. I would recommend Dr. Bolt to others because he is the most unique chiropractor or even doctor of any kind that I have ever met."
    Emily -