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Our Advanced Spine & Wellness offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive at our center for healing and better health.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Please fax your printed and completed form(s) to us at (845) 680-6139 or bring it with you to your appointment.


New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our chiropractic office.

You can print the form out and bring it in to our office during your next visit, or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form


Download the Free AdobeReader®

Sign-up using the form or call us at 201-297-1700
to make your appointment today!

THIS ---->https://rocklandchiropractorcom.chiromatrixbase.com/online-forms.html

Office Hours

DayMorningAfternoon
Monday9:00am - 1:00pm3:00pm - 7:00pm
Tuesday8:00am - 12:00pmClosed
Wednesday9:00am - 1:00pm3:00pm - 7:00pm
Thursday8:00am - 12:00pm3:00pm - 7:00pm
Friday9:00am - 1:00pmPM By Appt. Only
Saturday9:30am - 12:00pmClosed
SundayClosedClosed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
9:00am - 1:00pm 8:00am - 12:00pm 9:00am - 1:00pm 8:00am - 12:00pm 9:00am - 1:00pm 9:30am - 12:00pm Closed
3:00pm - 7:00pm Closed 3:00pm - 7:00pm 3:00pm - 7:00pm PM By Appt. Only Closed Closed

Testimonial

When I first arrived at Dr. Klayman's office, I had a "pinched nerve" in my lower back that was causing pain down to my left foot. Before arriving, I had already been diagnosed with a Herniated Disc. I could not sleep and I was limping when I walked, all because of the pain from the pinched nerve and Herniated Disc. I had tried other things before coming to see Dr. Klayman. I went to an Orthopedist, who referred me for an MRI. This showed the Herniation and Osteoporosis. The Orthopedist gave me 3 separate injections, epidurals and spinal injections at the hospital. I got NO RELIEF! I had doubts that a Chiropractor could help me, but I decided to try Dr. Klayman’s approach. Once I began care with Dr. Klayman, I started noticing a cessation of my nerve pain. I noticed that I was feeling better, sleeping better and limping less and less. My experience with Dr. Klayman and the Chiropractic Wellness Center can be described as “RELIEF from my Nerve Pain!”

Laurel
Northvale, NJ

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