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Online Forms

Atlantic Chiropractic and Rehabilitation offers our patient form(s) online so they can be completed it 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) to 757-547-2027 or bring it with you to your appointment.

New Patient Forms- 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!

Download Print and Complete Patient History Form

Download & Complete EHR Intake Form

Download, Print & Complete Patient Consent

Download, Print, & Complete Patient Intake

Please choose the form(s) below that best describes your chief complaint(s)

Download & Print Low Back Pain Form

Download & Print Knee Form

Download & Print Neck Form

Download & Print Shoulder Form

Download & Print Upper Extremity Form

Download & Print Hip Pain Oswestry

If you were involved in an accident and need Personal Injury Forms, Please print the following:

Personal Injury Forms

Download Print and Complete Patient History Form

Assignments of Benefits Form

EHR Form


New Patient Massage Forms - 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!

Download & Print Form


Download the Free AdobeReader®

Location

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Office Hours

Our Regular Schedule

Monday:

8:00 am-12:30 pm

3:00 pm-6:30 pm

Tuesday:

8:00 am-12:30 pm

3:00 pm-6:30 pm

Wednesday:

8:00 am-12:30 pm

3:00 pm-6:30 pm

Thursday:

Closed

Friday:

8:00 am-12:30 pm

3:00 pm-6:30 pm

Saturday:

Emergency

Sunday:

Emergency

Testimonials

Reviews By Our Satisfied Patients

  • "I love coming here! They offer great chiropractics and massage therapy. I always leave feeling better. Dr.Santer and the team are always so welcoming and make me feel like we have been friends for years. You truly feel they care about you. It is easy to set up and appointment and they are very understanding when something comes up. I like the office and staff so much and think they do such an amazing job! I tell all my friends and family about it. Thank you everyone for all you do!!!"
    Dominique C., Chesapeake, VA
  • ""I first came to Atlantic Chiropractic 5 years ago with a pinched nerve in my neck. I was in so much pain, I could not even move my head. Dr. Eric diagnosed the problem almost immediately and confirmed it with the EMG. He set up a treatment plan and told me I probably would not feel significant relief for a good two weeks. I appreciated his thoroughness, expertise, and honesty. As it turned out, I was actually pain free in one week! I always refer my friends to Dr. Eric/Atlantic Chiropractic and Rehabilitation for the most trusted effective chiropractic care.""
    Michelle G., Chesapeake, VA