hero image global header

New Patient Paperwork

Chiropractic Spine Center offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • All forms are PDF files. You will need AdobeReader® to view them.
  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Fax us your printed and completed form(s) or bring them with you to your appointment.

OFFICE HOURS


Monday
8:00am - 7:00pm


Tuesday
8:00am - 7:00pm


Wednesday
8:00am - 7:00pm


Thursday
8:00am - 7:00pm


Friday
8:00am - 1:00pm

Chiropractic Spine Center
744 West Lancaster Avenue #105
Wayne, PA 19087
(610) 254-8200

"After years of competitive sports, I thought that my knee pain was something I should expect. I could not have guessed that working with Dr. Glazer to align my back and hips could correct old injuries. Injuries that I assumed were par for the course. I only wish I had come to see him ten years sooner.."

Simona

"Within an hour of his adjustment I’m 90% free of symptoms, then within 3 hours they are gone completely. It is nothing short of amazing. I will continue to recommend Dr. Glazer to everyone I know."

Ann

"Dr. Ted is simply the best Chiropractor on the Mainline. I went to his office because I fell and couldn’t walk without a lot of pain. After the first treatment, I felt so much better. Now, about 3 weeks later, I am pain-free. Dr. Ted is so caring, gentle, and knowledgeable about all kinds of injuries."

Susan