Online Forms

Simmons Family Chiropractic PLLC 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 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


Download the Free AdobeReader®

New patients receive a COMPLIMENTARY CONSULTATION!

Sign-up using the form or call us at 304-925-5003 to take advantage of this exclusive offer.

Office Hours

Monday:

8am

6pm

Tuesday:

8am

6pm

Wednesday:

8am

6pm

Thursday:

8am

6pm

Friday:

8am

12:30pm

Saturday:

Closed

Closed

Sunday:

Closed

Closed

Location

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Testimonial

  • "Dr. Simmons is a lifesaver!! As a nurse I'm on my feet a lot and the pain in my back and hips was starting to interfere with my job. After a few visits with Dr. Simmons the pain and tightness in my back and hips was totally diminished and I can work a shift plus some and be totally pain free. She is also a delightful person! I look forward to my regular visits with her!"
    Amy K. / Charleston, WV

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