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Affinity Chiropractic & Wellness 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.

Initial Consultation Form

You should fill this out if you are new to our office.

Download & Print Form


Symptom Survey Form

We encourage all our patients to take an active role in their healing process. One huge way you can do this is improving your nutrition, which will improve your healing. Fill out this form, give it to the doctor and she will use it as a part of a nutritional consultation to determine areas where you can help yourself in your daily life.

Download & Print Form


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our chiropractic office. You can print the form out and bring it in to our office during your next visit with our chiropractor, or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form



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Exclusive Offer

Now Accepting New Patients

Sign-up using the form or call us at (281) 376-7700

Business Hours

DayMorningAfternoon
Monday9-12:302:30-6:15
Tuesday9-12:302:30-6:15
Wednesday9-12:302:30-6:15
Thursday9-12:302:30-6:15
Friday9-1Closed
SaturdayClosedClosed
SundayClosedClosed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
9-12:30 9-12:30 9-12:30 9-12:30 9-1 Closed Closed
2:30-6:15 2:30-6:15 2:30-6:15 2:30-6:15 Closed Closed Closed