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Florence

1747 21st St.

Florence, OR 97439

(541)-902-0545

Reedsport

2213 Winchester Ave

Reedsport, OR 97467

541-902-0545

Online Forms

Pacific Heights Chiropractic and Wellness Clinic offers our patient form(s) online so they can be completed 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.

New Patient Intake Form - Required

Download & Print Form

New Patient Personal Injury Intake Form - Required

Download & Print Form

Daily Notes Form - Required

Download & Print Form


Download the Free Adobe Reader®

CONTACT US TODAY

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Locations

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Office Hours

Our Regular Schedule

Reedsport Office

Monday:

Closed

Tuesday:

9:00 am-5:00 pm

Wednesday:

Closed

Thursday:

9:00 am-5:00 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed

Florence Office

Monday:

9:30 am-5:00 pm

Tuesday:

Closed

Wednesday:

9:30 am-5:00 pm

Thursday:

Closed

Friday:

9:30 am-5:00 pm

Saturday:

Closed

Sunday:

Closed