Online Forms

Freeport Family Chiropractic 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 Form - Required

Fill out it Online

PIP/Workmans Compensation

Download and Print Form


Download the Free Adobe Reader®

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We look forward to hearing from you

Our Locations

Hours of Operation

Office Hours

Monday:

8:30 am-7:00 pm

Tuesday:

8:30 am-7:00 pm

Wednesday:

Closed

Thursday:

8:30 am-7:00 pm

Friday:

8:30 am-2:00 pm

Saturday:

Closed

Sunday:

Closed

Doctor's Hours

Monday:

9:00 am-6:30 pm

Tuesday:

9:00 pm-6:30 pm

Wednesday:

Closed

Thursday:

9:00 pm-6:30 pm

Friday:

9:00 am-1:00 pm

Saturday:

Closed

Sunday:

Closed

David Cuchens Massage Hours | MM# MA50136

Monday:

4:00 pm-7:00 pm

Tuesday:

4:00 pm-6:00 pm

Wednesday:

Closed

Thursday:

4:00 pm-6:00 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed