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New Patient Forms

Home   New Patient Forms
Please download and complete the appropriate form before your first visit. Bringing a completed form will help us serve you more efficiently and allow more time for your examination.
Have questions before your visit? Call us at (408) 363-1991 — we are happy to help.

Ready to Start Feeling Better?

Your new patient exam at Vitality Chiropractic includes a full consultation, comprehensive examination, initial X-rays, and a personalized care plan — all for just $142 (reg. $389). Most patients feel a difference within their first few visits.
As your care progresses, we also take follow-up X-rays so you can see your results in measurable, objective terms — something most chiropractic offices simply don’t do.
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us
Please do not submit any Protected Health Information (PHI).
Office hours 
& location
Monday
8:00 am - 12:00 pm | 3:00 pm - 6:00 pm
Tuesday
3:00 pm - 6:00 pm
Wednesday
8:00 am - 12:00 pm | 3:00 pm - 6:00 pm
Thursday
3:00 pm - 6:00 pm
Friday
8:00 am - 12:00 pm | -
Saturday & Sunday
Closed
Vitality Chiropractic
6940 Santa Teresa Blvd, Suite #2
San Jose, CA 95119
We help individuals overcome pain and regain their mobility, providing personalized care solutions to help you get back to doing what you love quickly and effectively.
OUR LOCATION
6940 Santa Teresa Blvd, Suite #2
San Jose, CA 95119