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TO SCHEDULE AN APPOINTMENT OR REQUEST INFORMATION 

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Providing excellent chiropractic care to York, East York, York City and West York, Pennsylvania since 1996. Participating with all insurance, including Highmark , CareFirst , Medicare , any Blue Cross/ Blue Shield plans.

Online Forms

AquaMassage & Chiropractic 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.e of the items necessary for your chiropractic visit prior to arriving, in the comfort of your own home. If you have any questions at any time, please don't hesitate to contact our York chiropractic office at (717) 757-0610!

  • If you do not already have AdobeReaderĀ® 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.

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 & Print Form