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Book An Appointment

Please fill out the form below to book an appointment at Brink Chiropractic Clinic.  One of our three Chiropractic Assistants will be in touch with you as soon as they are able to confirm your appointment.  At Brink Chiropractic Clinic we work to ensure that each patient not only receives the best care, but also has the best experience while in our office.  If you have any questions or comments about our office, booking an appointment, or chiropractic care, please do not hesitate to contact us.

Medicine doctor hand working with modern medical icons

Personal organizer or planner with pen on white background

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1-207-324-5753 drbrink@myfairpoint.net

207.324.5753

info@brinkchiropractic.com 

1047 Main Street Sanford, ME 04073

Patient Forms

At Brink Chiropractic Clinic, we have one goal in mind: to help our patients lead healthy, pain-free lives.  Because of this, we want to ensure that your experience with our office is as pleasant, efficient, and effective as possible.  Common Patient Forms can be found below and you will be instructed by one of our three Chiropractic Assistants as to what you will need to bring with you when scheduling or confirming your appointment.  If you have any questions, please do not hesitate to contact us and we look forward to serving you in our office.

For your convenience, there are two styles of forms available online. You may select, fill out, and submit our online form through the “Online Form” tab below, or you may print and fill out a hard-copy through the “Printable Forms” tab below.

Click below to complete the online version of our Patient Intake Form. Once completed, please save this document to your computer or device and email the document as an attachment to info@brinkchiropractic.com. Thank you!

NEW PATIENT FORM – For all New and Re-activation Patients

AUTO INJURY INFO – For all Auto Injury Patients

LOW BACK PAIN QUESTIONNAIRE – Questionnaire for all Patients with Mid to Low Back Pain

NECK PAIN QUESTIONNAIRE – Questionnaire for all Patients with Neck and/or Upper Back Pain

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