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Online Forms

Galligan Family Chiropractic 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.
  • Bring your printed and completed form(s) with you to your appointment.

New Patient Health History Form - 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


Forms For Your First Appointment

Please print the following forms and fill out to bring with you to your first appointment. Please also bring any medications or nutritional supplements you are taking.

Terms of Acceptance Form

Download & Print Form

Disclosure of Healthcare Information Form

Download & Print Form

Authorization For X-Rays Form

Download & Print Form

New Dog Patient Form

Download & Print Form


Download the Free Adobe Reader®

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Location

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Office Hours

Our Regular Schedule

Wilmington Office

Monday, Wednesday, Thursday:

9:00 am - 12:00 pm

4:00 pm - 6:00 pm

Tuesday:

4:00 pm - 6:00 pm

Friday, Saturday:

We are open for Animal Barn Calls by appointment only. Call 910.790.4575

Sunday:

Closed