Step 1: Pick a category
Chiropractic Adjustment: This is for current patients only
New Chiropractic Patient: This is for a new patient that has never been seen at this clinic.
Step 2: Choose a Time Slot
Each time slot is a group of increment times. Choose the preferred time slot then refine it with the increment that works best for you.
Step 3: Fill in Your Information
Current Patients: Please type your name in as it shows on your drivers license. Do not use nicknames, middle names or any other names people may call you.
New Patients: Please type your name in as it shows on your drivers license. Do not use nicknames, middle names or any other names people may call you.
New Patients:
Once you make an appointment we will get an approval notification. When your appointment is approved, you will receive an email and text for further information to fill out. If you have any questions, please call us at 805-967-1254.
You will use your birthdate and authentication code (found in the text/email) to start the form.
ATTENTION: The birthdate calendar starts with 2025. Make sure you change this to the appropriate year.
Please fill out everything in the form to make your visit smooth and efficient. The doctor needs this information to best assist you.
When you are done filling out the form, click on the green button on the bottom right to save the form. Enter your birthdate and authentication code again.