Accessibility View Close toolbar

Primary Location

1726 S. 3rd St.

Ironton, OH 45638 US

(740) 532-1016

New Patient Forms

DuFore Chiropractic 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 and Print Form


Patient Insurance Form

Download and Print Form


Patient Pain Form

Download and Print Form


Consent For Treatment 

Download and Print Forms


Acupuncture Consent Form

Download and Print Form


Nutritional Consent Form

Download and Print Form


Privacy Practice Form

Download and Print Form

CONTACT US TODAY

We look forward to hearing from you

Locations

Find us on the map

Office Hours

Our Regular Schedule

Monday:

9:00 am-12:00 pm

1:30 pm-5:00 pm

Tuesday:

9:00 am-12:00 pm

Closed

Wednesday:

9:00 am-12:00 pm

1:30 pm-5:00 pm

Thursday:

9:00 am-12:00 pm

1:30 pm-5:00 pm

Friday:

9:00 am-12:00 pm

Closed

Saturday:

By appointment

Closed

Sunday:

Closed