New Patients

New Patient Forms

Protect Your Neck Mobile Chiropractic, PLLC would like to thank you for choosing us for your spinal health needs. Another way that we help to make our services convenient to you is there is no paperwork to print off and fill out. All records can be completed online through our patient portal. Please fill out all the information below and you will receive your patient portal link within 24 hours. All forms must be completed prior to booking your new patient appointment. Thank you and we look forward to helping you “Protect Your Neck!”

Booking Appointments

Protect Your Neck Mobile Chiropractic is unlike any other office in the Mecklenburg county area. All appointments would have to be booked directly with the doctor, to ensure that there are not scheduling conflicts. Once notification is received that all new patient forms have been completed, the doctor will contact you to determine the best time to schedule your appointment. Once an appointment time is agreed upon, the $50 booking fee will be due in order to reserve the appointment. The booking fee will be applied to services rendered at the appointment.

Medicare Eligible

Due to the nature of our business, unfortunately, at this time we are unable to accept patients that are Medicare eligible. Even though we are unable to treat patients that fall into this category, we are happy to assist you in finding a provider that can help treat your conditions.