If you need a more accessible version of this website, click this button on the right. Switch to Accessible Site


You are using an outdated browser. Please upgrade your browser to improve your experience.

Close [x]

Follow Us

Cheshire Wellness Center offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic 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 Comprehensive Health Profile & History - Required

So that we can best address your needs, we ask that all first time visitors fill out a comprehensive health profile. This profile helps identify what areas need the most attention and what type of care we would advise.

Simply download the form, and fax it to us at: 603-357-5151, or bring it with you on your first appt. You may email us or call 603.357.5700, to set up your first visit, or with any questions or comments.

Download & Print Form

Download the Free AdobeReader®