Me Strong - 10 Years Stronger
Phone: (386) 337-3884


Please submit your forms via one of the following three methods. If you do not have access to a printer please use method 1. If you are on a mobile device, download and editing abilities may be limited depending on available apps so you may need to access forms from a desktop.

1. Fill Out Online

New Patient Application

Click Here

Auto Accident Form

Click Here
includes new patient application


2. Print Out and Complete by Hand to Bring In

  • Click on the form (if you are unable to open the document, download the free Adobe Acrobat Reader by clicking here)
  • Print out the form using your browser's print command
  • Complete the form and bring it to your first office visit

Good Faith Estimate


DeLand Chiropractic & Spinal Decompression complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. DeLand Chiropractic & Spinal Decompression does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.