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Online Forms

Ajax Family Chiropractic 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) or bring it 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 (Adults)

Download & Print Form (Children)


Download the Free AdobeReader®

Locations

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Office Hours

Our Regular Schedule

Ajax Office

Monday:

7:45 am-12:00 pm

2:00 pm-6:45 pm

Tuesday:

7:45 am-12:00 pm

2:00 pm-6:45 pm

Wednesday:

7:45 am-12:00 pm

2:00 pm-6:45 pm

Thursday:

7:45 am-12:00 pm

2:00 pm-6:45 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed

Testimonials

Reviews By Our Satisfied Patients

  • "Dr. Mark and Dr. Mike are both dedicated doctors who go out of their way for their patients, and are constantly striving to provide the best care possible. Highly recommended!"
    Byron M.
  • "I've known Dr. Mark and Dr. Mike for more than a decade now. I have always been so impressed by them and their commitment to the people they serve. They are truly gifted Doctors and healers! Thanks Dr. Mike and Dr. Mark for all you do for me and so many others!"
    Mark F.