Needed Forms

The following are a list of downloadable forms to help speed your visit. Just click the link, a new window will open with the desired form. Just print, fill in the information and bring it with you to your next visit.

Feel free to call if you have any questions at all.

Patient Information Form

Patient Intake Form

Patient Information Form - Spanish

Medical Records Request

Auto Accident Questionaire

Auto Accident Questionaire - Spanish

Headache Form

Neck Pain Form

Lower Back Pain Form

contact us today!
336-625-9191

Call today to schedule an appointment !

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Business Hours

Mon 8:30am 6:00pm
Tue 8:30am 6:00pm
Wed 8:30am 6:00pm
Thur 8:30am 6:00pm
Fri 8:30am 11:30am
Sat closed  
Sun closed  

Our Mission

Our mission at Salyer Chiropractic is to provide affordable, high quality care to people of all ages, in a state of the art facility offering a wide range of diagnostic and treatment options. We strive to not only correct a person’s health problem, but to educate and enlighten people so that they do not encounter similar problems in the future.