Advanced Chiropractic Center is pleased to serve Asheville and the surrounding Western North Carolina region. Set up an appointment by calling 828-667-8000.
Special Offer for New Patients
The care you need…the savings you want!
New Patient Intake Forms
- Authorization for Release of Patient Records
- Office Intake and HIPAA Notice of Privacy (9 pages)
- Pain Diagram
- Functional Rating
- *Back Pain Questionnaire (*only required if you are experiencing back pain)
- *Peripheral Nerve Localization Form (*only required if you are experiencing upper or lower extremity pain)
Functional Neurology Intake Forms
- *Brain Region Localization Form (*please fill out pages 1-3. Page 4 only required if you are experiencing seizures)
- *Vestibular Intake Form (*only required if you are experiencing dizziness)
Functional Medicine Intake Forms
Adult Functional Medicine
- Authorization for Release of Patient Records
- HIPAA Notice of Privacy
- Metabolic Assessment
- NeuroTransmitter Assessment
Child Functional Medicine