For Children (up to age 18)

**All forms must be filled out, in full, and signed by the child's parent or guardian**

For Adults (ages 18 and older)

**All forms must be filled out, in full, and signed**

Download the MyChiroTown App Now!
Enter our clinic's ID: PCP0012

Intake Forms

Towers Family Chiropractic

"Affordable care for the entire family"