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Sign-up using the form or call me at 325-703-1022 or call or text my cell phone 510-432-2924 to take advantage of this exclusive offer.

Online Forms

Activated Life Chiropractic 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.
  • Click on the green "https" link below and fill in the required information. Click on the captcha to let us know your are real.
  • Sign and click submit and it will come to the office. This will also make your first visit a little faster.

Online New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know! Click the link below, fill out the information, sign, click the captcha to let us know you are a real person and click submit.

https://www.mychirotouch.com/p...




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