New Practice Member Application

Lifetime Family Chiropractic offers our practice member form(s) online, so they can be completed conveniently in your own home or office.

New Patient Intake Form
Click Here to Complete

The following forms are PDF files and can be downloaded and printed off.

  • All of the forms are PDF files. You will need AdobeReader® to view them.
  • If you do not already have AdobeReader® installed on your computer,
    Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Fax us your printed and completed form(s) or bring them with you to your appointment.
Pregnant New Practice Member Application Form
Click Here to Download
Insurance Verification Form
Click Here to Download

OFFICE HOURS

Monday
9:00am - 12:00pm
2:00pm - 7:00pm

Tuesday
2:00pm - 5:00pm

Wednesday
9:00am - 12:00pm
2:00pm - 6:00pm

Thursday
9:00am - 12:00pm
2:00pm - 6:00pm

Friday
Closed

Saturday
Closed

Lifetime Family Chiropractic
7487 Grand River Road
Brighton, MI 48114
(810) 588-6314