Pediatric New Patient

We’re excited to get to know you better and determine how we can best help you and your family. We also want you to get to know us better, so please explore this site. We look forward to meeting you!


Please complete the following steps to receive your 1st Day Services, a $185 value, for just $67: 

1. Watch the video below

2. Submit the answers to the questions below the video. 

3. The Pediatric New Patient form will pop up once you submit the answers to the questions below. Print the form to fill out.

If you do not have a printer, please arrive 15 minutes early to your appointment to fill out the forms.

 1st Day Services include:

Comprehensive Health Consultation

Specific Spinal Health Examination

Computerized Nervous System Evaluation

$185 value-Just $67 when you watch this 28 minute video and answer the questions in the form below.


We are excited to meet you! 

Pediatric New Patient Form

  • Please enter your name in the fields below
  • Please enter your email in this form.
  • Be as specific as possible.