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Online Forms

Raveling Chiropractic Center, P.A. offers our patient form(s) online so you can complete it in the convenience of your own home or 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.
  • If you would like a copy of our HIPPA form, please Click Here.

New Patient Forms - Required

This let's 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 Forms - Medicare

Download & Print Forms - General­

Download & Print Form - Personal Injury­ 


HIPPA Privacy Practices 

Download & Print Form



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Location

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Office Hours

Our Regular Schedule

Monday:

8:00 am-12:00 pm

2:00 pm-6:00 pm

Tuesday:

8:00 am-4:00 pm

Wednesday:

8:00 am-12:00 pm

2:00 pm-6:00 pm

Thursday:

Closed

Friday:

8:00 am-12:00 pm

2:00 pm-6:00 pm

Saturday:

Closed

Sunday:

Closed

Testimonials

Reviews By Our Satisfied Patients

  • "I had major lower back pain caused by poor seating on airline flight. I have to travel two weeks a month and the seating often throws my back out. I get adjusted once a month and my back is now pain free!!! I wouldn't miss a session for anything!"
    Scott Keebler - 12/17/09
  • "I came to Dr. Raveling's office with severe back pain. I could not straighten up or sit and could hardly walk. I have had some back problems for years but not this bad. Only chiropractic helps. I came to Dr. Ravelling's expecting to be helped with walking and sitting and to live a more normal life. I come in whenever my back hurts as I have arthritis. I am 99% better as a result of treating with Dr. Raveling."
    Dolly Whitehead - 1/30/07