New Patient Paperwork

Harrisburg Chiropractic offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • All forms are PDF files. You will need AdobeReader® to view them.
  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Fax us your printed and completed form(s) or bring them with you to your appointment.

Insurance Accepted

We accept most insurance plans. In fact, we bill auto and work injuries to your insurance so that you potentially pay nothing out of pocket! For those who don’t have insurance, or don’t have chiropractic benefits, we offer affordable interest-free payment plans so that you can easily obtain the care you need.

Please contact us if you have any questions. We’d love to see how we can help!


8:00am - 12:00pm
2:30pm - 6:00pm

8:00am - 12:00pm
2:30pm - 6:00pm

8:00am - 12:00pm

8:00am - 12:00pm
2:30pm - 6:00pm

8:00am - 10:30am


Harrisburg Chiropractic
12020 University City Boulevard
Harrisburg, NC 28075
(704) 455-2211