Grand Rapids

(616) 281-2500

Wayland

(269) 792-9050

Online Forms

DeYoung 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), fill in the required information.
  • Share your completed form by emailing it to: [email protected] or
  • Patients without AdobeReader®: Print the completed forms to bring with you to your appointment or fax to 616-281-2502

New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness that's prompting you to seek Chiropractic Care. 

New Patient Forms


Records Release

Submit the following form to authorize a Provider or Office to release your medical records to our office. 

 Specifically, any recent spinal imaging (X-Rays, MRI, etc.).

Authorization to Request Medical Records

CONTACT US TODAY

We look forward to hearing from you

Locations

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Office Hours

Our Regular Schedule

Grand Rapids

Monday, Wednesday:

7:30 am - 12:00 pm

3:00 pm - 6:00 pm

Tuesday, Thursday:

7:30 am - 12:00 pm

1:00 pm - 4:00 pm

Friday:

7:30 am - 12:00 pm

Saturday, Sunday:

Closed

Wayland

Monday, Wednesday, Thursday:

8:00 am - 1:00 pm

3:00 pm - 6:00 pm

Tuesday, Friday:

8:00 am - 12:00 pm

Saturday, Sunday:

Closed

Grand Rapids Massage Therapy

Monday - Wednesday:

9:15 am - 6:45 pm

By Appointment Only

Thursday:

9:15 am - 12:30 pm

By Appointment Only

Friday - Sunday:

Closed

Wayland Massage Therapy

Monday:

9:00 am - 6:00 pm

By Appointment Only

Tuesday, Wednesday, Saturday, Sunday:

Closed

Thursday:

By Appointment Only

3:00 pm - 6:45 pm

Friday:

9:15 am - 1:00 pm

By Appointment Only